Miller, Jason Douglas

Miller, Jason Douglas is an sole proprietor health care provider with primary practice located at 1921 Coborn Boulevard , St. Cloud MN 56301. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Miller, Jason Douglas can be contacted via phone (320) 251-5505.

Contact Information

Primary practice address
1921 Coborn Boulevard St. Cloud MN 56301
Phone: (320) 251-5505
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 120389 Minnesota

Profile Details

NPI number 1952692790
LBN Legal business name Miller, Jason Douglas
Credentials PHARM D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 27th, 2011
Last updated Oct 17th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952692790 NPPES
Minnesota MEDICAID 361660000

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