Provider Demographics
NPI:1578877544
Name:DROZDA, JASON PAUL (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:PAUL
Last Name:DROZDA
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 WINDSOR GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-6085
Mailing Address - Country:US
Mailing Address - Phone:575-520-2968
Mailing Address - Fax:
Practice Address - Street 1:424 N BRIGHTLEAF BLVD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4674
Practice Address - Country:US
Practice Address - Phone:919-989-4058
Practice Address - Fax:919-989-4055
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist