Provider Demographics
NPI:1982996013
Name:JARVIS, ALAN K (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:K
Last Name:JARVIS
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 1:93 N PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:THE PLAINS
Mailing Address - State:OH
Mailing Address - Zip Code:45780-1016
Mailing Address - Country:US
Mailing Address - Phone:740-797-2546
Mailing Address - Fax:
Practice Address - Street 1:93 N PLAINS RD
Practice Address - Street 2:
Practice Address - City:THE PLAINS
Practice Address - State:OH
Practice Address - Zip Code:45780-1016
Practice Address - Country:US
Practice Address - Phone:740-797-2546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122345183500000X
WVRP0007591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist