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General NPI Number Information
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NPI Number | 1659961092
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Entity Type | Individual
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Provider Name | JASON ANDREW PERRY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 2910 S ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80916-3000
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Country | US
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Telephone | 719-393-9688
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Fax |
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Provider Business Mailing Address
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Address Line | 320 AUTUMN RIDGE CIR UNIT B
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4876
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Country | US
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Telephone | 719-458-5069
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0022428
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License Number State | CO
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