Provider Demographics
NPI:1356626121
Name:BOCKIS, JASON ELLIOT (RPH)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:ELLIOT
Last Name:BOCKIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5195 N. HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1313
Mailing Address - Country:US
Mailing Address - Phone:614-476-0988
Mailing Address - Fax:
Practice Address - Street 1:5195 N. HAMILTON ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-1313
Practice Address - Country:US
Practice Address - Phone:614-476-0988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03223078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist