Healthcare Provider Details

I. General information

NPI: 1386779858
Provider Name (Legal Business Name): JAMES MICHAEL BOOTH PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S COMMERCE ST
GENEVA AL
36340-2420
US

IV. Provider business mailing address

1341 ENTERPRISE RD
GENEVA AL
36340-6313
US

V. Phone/Fax

Practice location:
  • Phone: 334-684-2272
  • Fax: 334-684-2273
Mailing address:
  • Phone: 334-684-2272
  • Fax: 334-684-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14153
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: