Individual
DR. JEREMY POPEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD,R.PH.
Contact information
Practice address
811 E DIVISION ST, SPRINGFIELD, MO 65803-3115
(417) 866-3054
Mailing address
811 E DIVISION ST, SPRINGFIELD, MO 65803-3115
(417) 866-3054
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2007034316
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007034316
PHARMACIST LICENSE
MO
Enumeration date
11/17/2014
Last updated
11/17/2014
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