Individual
JORDAN CANANKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1097 FLEDDERJOHN RD, CHARLESTON, WV 25314
(304) 345-3627
(304) 346-4440
Mailing address
21961 NE CHINOOK WAY, FAIRVIEW, OR 97024-8615
(814) 644-1581
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03237491
OH
183500000X
Pharmacist
RP0010235
WV
183500000X
Pharmacist
RPH-0016706
OR
1835P2201X
Ambulatory Care Pharmacist
Primary
RPH-0016706
OR
Other
Enumeration date
03/05/2018
Last updated
08/08/2018
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