Provider Demographics
NPI:1063701696
Name:STASCHIAK, JON DOUGLAS (BS PHARMACY)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:DOUGLAS
Last Name:STASCHIAK
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NORTH MAIN STREET
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:419-306-1064
Mailing Address - Fax:
Practice Address - Street 1:301 NORTH MAIN STREET
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-306-1064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03218082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist