MEDICARE: JASON KESSINGER

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	183500000X	Pharmacist	RP044866L	PA

General Provider Information

NPI Number	:	1437554920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON KESSINGER

Provider Business Mailing Address
First Line	:	1365 LOGAN AVE
Second Line	:
City	:	TYRONE
State	:	PA
Zip	:	16686-1638
Country	:	US
Telephone Number	:	814-684-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 LOGAN AVE
Second Line	:
City	:	TYRONE
State	:	PA
Zip	:	16686-1638
Country	:	US
Telephone Number	:	814-684-5000
Fax Number	:

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

Provider Enumeration Date	:	10/27/2014
Last Update Date	:	10/27/2014

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Directions to “ JASON KESSINGER ” Practice Location

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