Healthcare Provider Details

I. General information

NPI: 1215865233
Provider Name (Legal Business Name): JADE JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S MEMORIAL DR
LANCASTER OH
43130-4361
US

IV. Provider business mailing address

111 S MEMORIAL DR
LANCASTER OH
43130-4361
US

V. Phone/Fax

Practice location:
  • Phone: 740-653-2631
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number09146213
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: