Healthcare Provider Details
I. General information
NPI: 1295876233
Provider Name (Legal Business Name): JAMES A. GOOD R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/11/2007
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7250 PACIFIC AVE PHARMACY
TACOMA WA
98408-7128
US
IV. Provider business mailing address
816 QUEENS ST UNIT D
MILTON WA
98354-8880
US
V. Phone/Fax
- Phone: 253-475-6073
- Fax: 253-475-6082
- Phone: 406-459-0600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P1200X |
| Taxonomy | Pharmacotherapy Pharmacist |
| License Number | 3321 |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | PH 60191326 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: