Provider Demographics
NPI:1023371325
Name:BAUGHMAN, JASON A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:A
Last Name:BAUGHMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:9 S MAIN ST
Mailing Address - City:CEDARVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45314
Mailing Address - Country:US
Mailing Address - Phone:937-766-9900
Mailing Address - Fax:937-766-4766
Practice Address - Street 1:9 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDARVILLE
Practice Address - State:OH
Practice Address - Zip Code:45314
Practice Address - Country:US
Practice Address - Phone:937-766-9900
Practice Address - Fax:937-766-4766
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03331234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist