Healthcare Provider Details

I. General information

NPI: 1538215058
Provider Name (Legal Business Name): JAMES LEROW HODGES R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N PARLER AVE # NORTH
SAINT GEORGE SC
29477-2224
US

IV. Provider business mailing address

204 N PARLER AVE # NORTH
SAINT GEORGE SC
29477-2224
US

V. Phone/Fax

Practice location:
  • Phone: 843-563-3034
  • Fax: 843-563-3035
Mailing address:
  • Phone: 843-563-3034
  • Fax: 843-563-3035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number003959
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: