Provider Demographics
NPI:1255007068
Name:CASH, JAKE EDMUND (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAKE
Middle Name:EDMUND
Last Name:CASH
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 1:614 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:STAR CITY
Mailing Address - State:AR
Mailing Address - Zip Code:71667-5802
Mailing Address - Country:US
Mailing Address - Phone:870-628-4277
Mailing Address - Fax:
Practice Address - Street 1:614 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:STAR CITY
Practice Address - State:AR
Practice Address - Zip Code:71667-5802
Practice Address - Country:US
Practice Address - Phone:870-628-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14572183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist