Healthcare Provider Details

I. General information

NPI: 1073803615
Provider Name (Legal Business Name): JAMES RAYMOND PARR PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2011
Last Update Date: 04/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8531 E LANSING RD
DURAND MI
48429-1072
US

IV. Provider business mailing address

8531 E LANSING RD
DURAND MI
48429-1072
US

V. Phone/Fax

Practice location:
  • Phone: 989-288-3101
  • Fax:
Mailing address:
  • Phone: 989-288-3101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302021900
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: