MEDICARE: E.W. JAMES & SONS, INC

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	3336C0003X	Community/Retail Pharmacy	1247	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912011040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E.W. JAMES & SONS, INC

Provider Business Mailing Address
First Line	:	705 E REELFOOT AVE
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-5883
Country	:	US
Telephone Number	:	731-885-9441
Fax Number	:	731-885-7861

Provider Business Practice Location Address
First Line	:	705 E REELFOOT AVE
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-5883
Country	:	US
Telephone Number	:	731-885-9441
Fax Number	:	731-885-7861

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	DR. BOBBY J. RUSSELL
Credential	:	D.PH.
Telephone Number	:	731-885-9441

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	04/30/2012

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