Provider Demographics
NPI:1306134549
Name:CRAWFORD, JASON KARL (RPH)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:KARL
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18855 N MARKET PLACE DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8784
Mailing Address - Country:US
Mailing Address - Phone:330-562-0637
Mailing Address - Fax:330-562-0637
Practice Address - Street 1:18855 N MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8784
Practice Address - Country:US
Practice Address - Phone:330-562-0637
Practice Address - Fax:330-562-0637
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03127589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist