MEDICARE: MR. JASON M MCCARTHY

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	PS46910	FL

General Provider Information

NPI Number	:	1770979304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON M MCCARTHY

Provider Business Mailing Address
First Line	:	8429 CALABRIA LAKES DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33473-4946
Country	:	US
Telephone Number	:	561-509-9513
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 GATEWAY BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8312
Country	:	US
Telephone Number	:	561-732-6148
Fax Number	:

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

Provider Enumeration Date	:	04/10/2015
Last Update Date	:	04/10/2015

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