MEDICARE: JASON R STRONG PHARM D

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	E-09450	MS

General Provider Information

NPI Number	:	1174128425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON R STRONG PHARM D

Provider Business Mailing Address
First Line	:	104 SHORELINE DR
Second Line	:
City	:	MADISON
State	:	MS
Zip	:	39110-6828
Country	:	US
Telephone Number	:	601-853-1542
Fax Number	:

Provider Business Practice Location Address
First Line	:	726 E PEACE ST
Second Line	:
City	:	CANTON
State	:	MS
Zip	:	39046-4731
Country	:	US
Telephone Number	:	601-859-3827
Fax Number	:	601-859-3829

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

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	12/03/2020

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Directions to “ JASON R STRONG PHARM D” Practice Location

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