Provider Demographics
NPI:1932405495
Name:DAVIS, JASON R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:R
Last Name:DAVIS
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 1:219 N BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17065-1204
Mailing Address - Country:US
Mailing Address - Phone:800-266-9954
Mailing Address - Fax:800-266-9947
Practice Address - Street 1:219 N BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17065-1204
Practice Address - Country:US
Practice Address - Phone:800-266-9954
Practice Address - Fax:800-266-9947
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4417851835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric