Provider Demographics
NPI:1811283674
Name:HOWARD, JASON SCOTT (RPH)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:SCOTT
Last Name:HOWARD
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 1:815 W 2000 N
Mailing Address - Street 2:T-1755
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1632
Mailing Address - Country:US
Mailing Address - Phone:801-773-6478
Mailing Address - Fax:801-773-6478
Practice Address - Street 1:815 W 2000 N
Practice Address - Street 2:T-1755
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1632
Practice Address - Country:US
Practice Address - Phone:801-773-6478
Practice Address - Fax:801-773-6478
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT339609-1701183500000X
IDP6239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist