Healthcare Provider Details

I. General information

NPI: 1568760767
Provider Name (Legal Business Name): JAMES LAWRENCE STANSELL BS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601REYNOLDA RD
WINSTON SALEM NC
27106-2229
US

IV. Provider business mailing address

3601REYNOLDA RD RIT AID
WINSTON SALEM NC
27106-2229
US

V. Phone/Fax

Practice location:
  • Phone: 336-924-9366
  • Fax:
Mailing address:
  • Phone: 336-924-9366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7884
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: