Healthcare Provider Details

I. General information

NPI: 1457856767
Provider Name (Legal Business Name): JAMES MICHAEL KUGLER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 06/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 MAIN ST
OWEGO NY
13827
US

IV. Provider business mailing address

1469 RIVER RD APT 1
BINGHAMTON NY
13901-5639
US

V. Phone/Fax

Practice location:
  • Phone: 607-687-0891
  • Fax:
Mailing address:
  • Phone: 315-750-8174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI063202-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: