Healthcare Provider Details

I. General information

NPI: 1801276233
Provider Name (Legal Business Name): JAYSON SCOTT GEORGE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 06/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6090 RTE 30
GREENSBURG PA
15601-1279
US

IV. Provider business mailing address

6090 RTE 30
GREENSBURG PA
15601-1279
US

V. Phone/Fax

Practice location:
  • Phone: 724-837-4180
  • Fax:
Mailing address:
  • Phone: 724-837-4180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP449283
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: