Alex Damon Jasper Sr., PHARM D.
Individual provider Active NPI Pharmacist · Prichard, AL
NPI 1104194752 · NPPES record last updated Dec 11, 2011
Key facts
- NPI
- 1104194752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 15696 (AL)
- Practice address
- 4544 Saint Stephens Rd
Prichard, AL 36613-3509 - Phone
- (251) 330-1631
- Fax
- (251) 330-1637
- NPI assigned
- Dec 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15696 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15696 | AL | Yes |
Addresses
Primary practice location
4544 Saint Stephens Rd
Prichard, AL 36613-3509
Mailing address
4544 Saint Stephens Rd
Prichard, AL 36613-3509
Phone (251) 330-1631
Other providers in Prichard, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.