Provider Demographics
NPI:1396344008
Name:BENDER, JASON ROBERT (PHARMD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ROBERT
Last Name:BENDER
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 1:546 COUNTRY RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8533
Mailing Address - Country:US
Mailing Address - Phone:410-652-2323
Mailing Address - Fax:
Practice Address - Street 1:1519 ROCK SPRING RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2833
Practice Address - Country:US
Practice Address - Phone:410-638-8757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27614183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist