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  7. NPI Record 1578045209

JEREMY ALLAN SULLENS
Complete NPI Record 1578045209
Pharmacist in Tucson, AZ

NPI Status: Active since August 29, 2018

Contact Information

3180 N CAMPBELL AVE
TUCSON, AZ
ZIP 85719
Phone: (520) 326-4509

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Provider Gender Code
  21. Healthcare Provider Taxonomy Code 1
  22. Provider License Number 1
  23. Provider License Number State Code 1
  24. Healthcare Provider Primary Taxonomy Switch 1
  25. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1578045209. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1578045209
The last name of the provider. If the provider is an individual, this is the legal name.
Entity Type Code: 1
The first name of the provider, if the provider is an individual.
The middle name of the provider, if the provider is an individual.
Provider First Name: JEREMY
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Middle Name: ALLAN
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 7990 E SNYDER RD APT 22101
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: TUCSON
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: AZ
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Postal Code: 857509047
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Country Code If outside U S : US
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address Telephone Number: 6183399009
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider First Line Business Practice Location Address: 3180 N CAMPBELL AVE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address City Name: TUCSON
The State code in the location of the provider being identified.
Provider Business Practice Location Address State Name: AZ
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Postal Code: 857192302
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5203264509
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 8/29/2018
The telephone number associated with the location address of the provider being identified.
Last Update Date: 8/29/2018
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 183500000X
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number 1: S023256
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider License Number State Code 1: AZ
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N