Provider Demographics
NPI:1164700126
Name:LOGAN-JONES, ASHLEY T (PHARM D)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:T
Last Name:LOGAN-JONES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12795 MAIN ST
Mailing Address - Street 2:T-2468
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-9110
Mailing Address - Country:US
Mailing Address - Phone:760-949-3064
Mailing Address - Fax:760-949-3134
Practice Address - Street 1:12795 MAIN ST
Practice Address - Street 2:T-2468
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-9110
Practice Address - Country:US
Practice Address - Phone:760-949-3064
Practice Address - Fax:760-949-3134
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist