Healthcare Provider Details

I. General information

NPI: 1538276571
Provider Name (Legal Business Name): JAMES THOMAS WOOD RPH, CDE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3868 HIGHWAY 431
ROANOKE AL
36274-2640
US

IV. Provider business mailing address

PO BOX 899
ROANOKE AL
36274-0899
US

V. Phone/Fax

Practice location:
  • Phone: 334-863-7511
  • Fax: 334-863-7500
Mailing address:
  • Phone: 334-863-7511
  • Fax: 334-863-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9914
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: