MEDICARE: DR. JAMES KEVIN GOROSPE PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH37695	CA

General Provider Information

NPI Number	:	1295735835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES KEVIN GOROSPE PHARM.D.

Provider Business Mailing Address
First Line	:	10036 DEER RIDGE DR
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-4315
Country	:	US
Telephone Number	:	916-833-5058
Fax Number	:	916-426-4284

Provider Business Practice Location Address
First Line	:	10036 DEER RIDGE DR
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-4315
Country	:	US
Telephone Number	:	916-833-5058
Fax Number	:	916-626-4284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	01/22/2021

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