Healthcare Provider Details

I. General information

NPI: 1336202688
Provider Name (Legal Business Name): KORY L. JOST R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180
US

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 496371867570
  • Fax: 496371865121
Mailing address:
  • Phone: 49637867570
  • Fax: 496371865121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28601
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: