Healthcare Provider Details

I. General information

NPI: 1295072288
Provider Name (Legal Business Name): JAMES WOODARD POOLE JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2013
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 INDUSTRIAL BLVD
DUBLIN GA
31021-1714
US

IV. Provider business mailing address

507 INDUSTRIAL BLVD
DUBLIN GA
31021-1714
US

V. Phone/Fax

Practice location:
  • Phone: 800-575-3160
  • Fax: 877-477-2499
Mailing address:
  • Phone: 800-575-3160
  • Fax: 877-477-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number012997
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: