Healthcare Provider Details

I. General information

NPI: 1407853906
Provider Name (Legal Business Name): JAMES KENNETH EASTER R.PH., MBA, FASCP
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MOBILE INFIRMARY MEDICAL CENTER 5 MOBILE INFIRMARY CIRCLE
MOBILE AL
36607
US

IV. Provider business mailing address

54 HAWTHORNE PL N
MOBILE AL
36608-2807
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-4097
  • Fax: 251-435-5145
Mailing address:
  • Phone: 251-343-7898
  • Fax: 251-435-5145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9284
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: