Provider Demographics
NPI:1942586813
Name:BRUMMETT, JASON RANDALL (PHARMD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:RANDALL
Last Name:BRUMMETT
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 1:13503 W CAMINO DEL SOL
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4439
Mailing Address - Country:US
Mailing Address - Phone:623-584-0501
Mailing Address - Fax:623-546-5538
Practice Address - Street 1:13503 W CAMINO DEL SOL
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4439
Practice Address - Country:US
Practice Address - Phone:623-584-0501
Practice Address - Fax:623-546-5538
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist