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General NPI Number Information
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NPI Number | 1013490978
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Entity Type | Individual
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Provider Name | JASON LEE RATLIFF PHARM D
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Gender | Male
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 740 SOUTH LIMESTONE STREET ROOM J-134
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-323-5855
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Fax |
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Provider Business Mailing Address
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Address Line | 932 HAMMOCK OAK LN
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City | LEXINGTON
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State | KY
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Zip | 40515-6455
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Country | US
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Telephone | 859-420-3416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P07583
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License Number State | KY
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