Provider Demographics
NPI:1356650394
Name:GROSS, JAMIN JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMIN
Middle Name:JOHN
Last Name:GROSS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:330 S 9TH ST
Mailing Address - Street 2:SUITE 180
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1266
Mailing Address - Country:US
Mailing Address - Phone:412-697-4882
Mailing Address - Fax:412-697-4897
Practice Address - Street 1:330 S 9TH ST
Practice Address - Street 2:SUITE 180
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1266
Practice Address - Country:US
Practice Address - Phone:412-697-4882
Practice Address - Fax:412-697-4897
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARP444583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist