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:
Health care specialties
| Specialty | Code | License # | 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 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952692790 | NPPES |
| Minnesota | MEDICAID | 361660000 |
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