Provider Demographics
NPI:1225319528
Name:CUMMINS, JAIME LYNN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LYNN
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:JAIME
Other - Middle Name:LYNN
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:153 GOLDENROD DR
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-2277
Mailing Address - Country:US
Mailing Address - Phone:937-533-2319
Mailing Address - Fax:
Practice Address - Street 1:1213 N BARRON ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-1013
Practice Address - Country:US
Practice Address - Phone:937-456-2694
Practice Address - Fax:937-456-5164
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03326814183500000X
IN26022114A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist