Healthcare Provider Details

I. General information

NPI: 1851074595
Provider Name (Legal Business Name): JAMES THOMAS ASH RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SOUTHPARK BLVD STE 206
ST AUGUSTINE FL
32086-3129
US

IV. Provider business mailing address

200 SOUTHPARK BLVD STE 206
ST AUGUSTINE FL
32086-3129
US

V. Phone/Fax

Practice location:
  • Phone: 904-295-3677
  • Fax: 904-295-3689
Mailing address:
  • Phone: 904-295-3677
  • Fax: 904-295-3689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS23375
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: