Provider Demographics
NPI:1215637731
Name:GRIFFITH, JASON (PHARM D)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4914 MONTAUK TRL SE
Mailing Address - Street 2:
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-8736
Mailing Address - Country:US
Mailing Address - Phone:256-390-7133
Mailing Address - Fax:
Practice Address - Street 1:704 PRATT AVE NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3644
Practice Address - Country:US
Practice Address - Phone:256-534-1118
Practice Address - Fax:256-534-1121
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist