Provider Demographics
NPI:1831967918
Name:STROSNIDER, JASON
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:STROSNIDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1155
Mailing Address - Street 2:
Mailing Address - City:EXMORE
Mailing Address - State:VA
Mailing Address - Zip Code:23350-1155
Mailing Address - Country:US
Mailing Address - Phone:757-442-7982
Mailing Address - Fax:757-442-7985
Practice Address - Street 1:3271 B MAIN ST
Practice Address - Street 2:
Practice Address - City:EXMORE
Practice Address - State:VA
Practice Address - Zip Code:23350
Practice Address - Country:US
Practice Address - Phone:757-442-7982
Practice Address - Fax:757-442-7985
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist