JASON BASHAM

CONWAY, SC
NPI1194181669
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: SC  9657)
Additional Taxonomies183500000X Pharmacist
(Licence: KY  011627)
Enumeration Date2016-01-13
Last Update Date2016-01-13
Business Address
-- JASON BASHAM
2219 MAIN ST
CONWAY, SC 29526-3340
Phone number: 843-488-4400
Mailing Address
-- JASON BASHAM
2219 MAIN ST
CONWAY, SC 29526-3340
Phone number: 843-488-4400