Healthcare Provider Details

I. General information

NPI: 1407841844
Provider Name (Legal Business Name): JAMES BRUCE MCGIRR RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2546 E 2ND ST
CASPER WY
82609-2047
US

IV. Provider business mailing address

2546 E 2ND
CASPER WY
82609-2062
US

V. Phone/Fax

Practice location:
  • Phone: 307-472-0597
  • Fax: 307-237-7731
Mailing address:
  • Phone: 307-472-0597
  • Fax: 307-237-7731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1869
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: