Individual
JASON CYRIL PATRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1613 N MAIN ST, SAN LUIS, AZ 85336-0667
(928) 722-7288
(928) 722-7290
Mailing address
PO BOX 5659, SAN LUIS, AZ 85349-5659
(928) 276-1243
(928) 722-7290
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18052
CO
183500000X
Pharmacist
S021643
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S021643
PHARMACIST LICENSE
AZ
Enumeration date
11/23/2011
Last updated
10/11/2022
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