Individual
MR. JEREMIAH MADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2306 N WAHSATCH AVE, COLORADO SPRINGS, CO 80907-6957
(719) 216-1640
Mailing address
2306 N WAHSATCH AVE, COLORADO SPRINGS, CO 80907-6957
(719) 516-1640
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16603
CO
183500000X
Pharmacist
KS1-13891
KS
Other
Enumeration date
08/26/2011
Last updated
01/30/2016
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