Provider Demographics
NPI:1821082488
Name:PLUMMER, JASON MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:MICHAEL
Last Name:PLUMMER
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 1:1808 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-2819
Mailing Address - Country:US
Mailing Address - Phone:606-324-4843
Mailing Address - Fax:
Practice Address - Street 1:600 MARION PIKE
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-2963
Practice Address - Country:US
Practice Address - Phone:740-533-2479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006328174H00000X, 183500000X, 1835N0905X
KY012669183500000X, 174H00000X
OH03-1-23865174H00000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No174H00000XOther Service ProvidersHealth Educator
No1835N0905XPharmacy Service ProvidersPharmacistNuclear