Provider Demographics
NPI:1053723924
Name:SCARTZ, JACLYN JO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JACLYN
Middle Name:JO
Last Name:SCARTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JACLYN
Other - Middle Name:JO
Other - Last Name:BARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1610 E CAMELBACK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3902
Mailing Address - Country:US
Mailing Address - Phone:602-277-1727
Mailing Address - Fax:401-262-4074
Practice Address - Street 1:1610 E CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3902
Practice Address - Country:US
Practice Address - Phone:602-277-1727
Practice Address - Fax:401-262-4074
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist