Provider Demographics
NPI:1134247562
Name:JONES, GRANT JEFFERIS (RPH)
Entity type:Individual
Prefix:MR
First Name:GRANT
Middle Name:JEFFERIS
Last Name:JONES
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 1:1331 CREEK BEND CT
Mailing Address - Street 2:
Mailing Address - City:ROSSFORD
Mailing Address - State:OH
Mailing Address - Zip Code:43460-1639
Mailing Address - Country:US
Mailing Address - Phone:419-666-8642
Mailing Address - Fax:419-865-6139
Practice Address - Street 1:2450 S REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1419
Practice Address - Country:US
Practice Address - Phone:419-865-3130
Practice Address - Fax:419-865-6139
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-14518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist