Healthcare Provider Details

I. General information

NPI: 1124232103
Provider Name (Legal Business Name): JAMES RUSSELL BELCHER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 TOWN CENTRE DR
ABINGDON VA
24210
US

IV. Provider business mailing address

27500 COOL BREEZE DR
ABINGDON VA
24211
US

V. Phone/Fax

Practice location:
  • Phone: 276-628-2580
  • Fax:
Mailing address:
  • Phone: 276-475-5282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202004547
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: