Jason Brozek, PHARMD, JD
Individual provider Active NPI Pharmacist · Fort Leavenworth, KS
NPI 1124639778 · NPPES record last updated Feb 16, 2023
Key facts
- NPI
- 1124639778
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 1-106241 (KS)
- Practice address
- 550 Pope Ave
Fort Leavenworth, KS 66027-2332 - Phone
- (913) 684-6250
- NPI assigned
- Aug 16, 2020
- Sex
- Male
- Sole proprietor
- No
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
- Juris Doctor, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-106241 | KS | MD | Pharmacist |
| 2018032016 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
2900 S 4th St
Leavenworth, KS 66048
Phone (913) 651-2027
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2018032016 | MO | |
| Pharmacist | 183500000X | 1-106241 | KS | Yes |
Addresses
Primary practice location
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Mailing address
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Phone (913) 684-6250
Other practice location 1
2900 S 4th St
Leavenworth, KS 66048-5002
Phone (913) 651-2027
Other providers in Fort Leavenworth, KS
- Tracy Katherine Bono-Johnson
- Diane Marie Booth
- Randy E Bradford
- Jennifer Klein Brewster
- Stephanie Renee Brooks
- Kenya Sade Bryant
- Dave Alan Buchheim
- Jennah Renae Bulen
- Nicole Burton
- Susan Leslie Carlson
All providers in Fort Leavenworth, KS · Pharmacist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2023. 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.