Provider Demographics
NPI:1912626060
Name:OLIVER, JASON HENRY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:HENRY
Last Name:OLIVER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CHESTNUT ST APT 1003
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4503
Mailing Address - Country:US
Mailing Address - Phone:484-477-2977
Mailing Address - Fax:
Practice Address - Street 1:150 N MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:GLENOLDEN
Practice Address - State:PA
Practice Address - Zip Code:19036-1224
Practice Address - Country:US
Practice Address - Phone:610-586-5224
Practice Address - Fax:610-586-5180
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457085183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist