Jason Alexander Wang, PHARM.D.
Individual provider Active NPI Pharmacist · Pevely, MO
NPI 1821373077 · NPPES record last updated Jun 11, 2024
Key facts
- NPI
- 1821373077
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2011020707 (MO)
- Practice address
- 8640 Commercial Blvd
Pevely, MO 63070-1529 - Phone
- (636) 479-6100
- Fax
- (636) 479-6101
- NPI assigned
- Oct 19, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
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 |
|---|---|---|---|
| 2011020707 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pevely RX | Current |
Accepting new patients | |
| Pevely RX | Past |
Accepting new patients | |
| Pacific RX Inc | Past | Accepting new patients | |
| Ms MGC Inc | Past | Accepting new patients | |
| Tomlyn, Inc | Past | Accepting new patients | |
| Ms MGC Inc | Past | Accepting new patients |
Locations
8640 Commercial Blvd
Pevely, MO 63070
Phone (636) 479-6100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2011020707 | MO | Yes |
Addresses
Primary practice location
8640 Commercial Blvd
Pevely, MO 63070-1529
Mailing address
8640 Commercial Blvd
Pevely, MO 63070-1529
Phone (636) 479-6100
Other practice location 1
2290 W Osage St
Pacific, MO 63069-1131
Phone (636) 257-9777
Other practice location 2
635 S Sturgeon St
Montgomery City, MO 63361-2707
Phone (573) 564-1111
Other practice location 3
7922 MacKenzie Rd
Saint Louis, MO 63123-2721
Phone (314) 638-3535 ext. 9
Other providers in Pevely, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2024. 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.