Provider Demographics
NPI:1023144052
Name:STRAIN, JASON L (RPH)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:L
Last Name:STRAIN
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 1:2951 AUGUSTA TRACE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-8210
Mailing Address - Country:US
Mailing Address - Phone:615-417-0629
Mailing Address - Fax:
Practice Address - Street 1:5270 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2494
Practice Address - Country:US
Practice Address - Phone:931-486-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist