Healthcare Provider Details

I. General information

NPI: 1871894469
Provider Name (Legal Business Name): JAMES INMAN KILE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 GUNN RD
CENTERVILLE GA
31028-8045
US

IV. Provider business mailing address

202 GUNN RD
CENTERVILLE GA
31028-8045
US

V. Phone/Fax

Practice location:
  • Phone: 478-953-8118
  • Fax: 478-953-5527
Mailing address:
  • Phone: 478-953-8118
  • Fax: 478-953-5527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH011059
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: