Healthcare Provider Details

I. General information

NPI: 1235259391
Provider Name (Legal Business Name): JAMES W WEST CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

IV. Provider business mailing address

20 WILSON ST
BEVERLY MA
01915-1131
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-2141
  • Fax:
Mailing address:
  • Phone: 978-922-2204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number918
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: