Provider Demographics
NPI:1386961654
Name:ASHLEY, JEREMY HEATH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:HEATH
Last Name:ASHLEY
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 1:13157 US HIGHWAY 271
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75708-2453
Mailing Address - Country:US
Mailing Address - Phone:800-825-9166
Mailing Address - Fax:903-877-3820
Practice Address - Street 1:13157 US HIGHWAY 271
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75708-2453
Practice Address - Country:US
Practice Address - Phone:800-825-9166
Practice Address - Fax:903-877-3820
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist