MEDICARE: JASON ALAN MULL PHARMD.

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	18249	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740513621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON ALAN MULL PHARMD.

Provider Business Mailing Address
First Line	:	2659 NC HWY 127 S
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602
Country	:	US
Telephone Number	:	828-294-7056
Fax Number	:

Provider Business Practice Location Address
First Line	:	2659 S NC 127 HWY
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-9129
Country	:	US
Telephone Number	:	828-294-7056
Fax Number	:

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

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	09/10/2009

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