Provider Demographics
NPI:1154947794
Name:WEBER, ALEX JASON (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:JASON
Last Name:WEBER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 S BYRNE RD APT A204
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2388
Mailing Address - Country:US
Mailing Address - Phone:567-277-7544
Mailing Address - Fax:
Practice Address - Street 1:1330 N REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-4760
Practice Address - Country:US
Practice Address - Phone:419-536-3840
Practice Address - Fax:419-536-4968
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03439178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist