Healthcare Provider Details
I. General information
NPI: 1295748309
Provider Name (Legal Business Name): JAMES MEDICAL PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2006
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1545 CAMPBELLSVILLE RD SUITE B
COLUMBIA KY
42728-2262
US
IV. Provider business mailing address
1545 CAMPBELLSVILLE RD SUITE B
COLUMBIA KY
42728-2262
US
V. Phone/Fax
- Phone: 270-385-9600
- Fax: 270-385-9631
- Phone: 270-385-9600
- Fax: 270-385-9631
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | PO6424 |
| License Number State | KY |
VIII. Authorized Official
Name:
WILLIAM
C
MILBY
JR.
Title or Position: TREASURER/OWNER
Credential:
Phone: 270-465-8220