Provider Demographics
NPI:1740944768
Name:HOSKINS, JASON (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HOSKINS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-8763
Mailing Address - Country:US
Mailing Address - Phone:606-813-8181
Mailing Address - Fax:
Practice Address - Street 1:560 MANCHESTER SQUARE SHPG CTR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-8779
Practice Address - Country:US
Practice Address - Phone:606-598-0414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY022409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist