Provider Demographics
NPI:1962834978
Name:HAMRICK, JASON LEE (RPH)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:LEE
Last Name:HAMRICK
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 1:3272 POLO CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8643
Mailing Address - Country:US
Mailing Address - Phone:304-549-7481
Mailing Address - Fax:
Practice Address - Street 1:260 E NEW CIRCLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-2117
Practice Address - Country:US
Practice Address - Phone:859-225-8903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist