Provider Demographics
NPI:1164240925
Name:CASTO, JASON REX
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:REX
Last Name:CASTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4127 STATE ROUTE 55
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-9612
Mailing Address - Country:US
Mailing Address - Phone:937-896-1111
Mailing Address - Fax:
Practice Address - Street 1:4127 STATE ROUTE 55
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-9612
Practice Address - Country:US
Practice Address - Phone:937-896-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide