Provider Demographics
NPI:1235506445
Name:SPRINGER, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:SPRINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 AL HIGHWAY 157
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-5913
Mailing Address - Country:US
Mailing Address - Phone:256-615-6666
Mailing Address - Fax:256-615-6656
Practice Address - Street 1:626 OLIVE ST SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5594
Practice Address - Country:US
Practice Address - Phone:256-739-3390
Practice Address - Fax:256-739-9125
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist