MEDICARE: DR. JASON JAMES EVERLY PHARM.D., R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	RPH021809	GA
2	1835P1200X	Pharmacotherapy Pharmacist	03325555	OH

General Provider Information

NPI Number	:	1407850001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON JAMES EVERLY PHARM.D., R.PH.

Provider Business Mailing Address
First Line	:	8020 VEGAS CIR
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-9290
Country	:	US
Telephone Number	:	513-860-0407
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 PARKWOOD CIRCLE SE
Second Line	:	SUITE 325 ECG, LLC,,
City	:	ATLANTA
State	:	GA
Zip	:	30339
Country	:	US
Telephone Number	:	513-846-7283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	04/17/2013

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