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General NPI Number Information
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NPI Number | 1003025339
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Entity Type | Individual
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Provider Name | JAMES D WURST PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1725 PINE ST
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City | MONTGOMERY
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State | AL
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Zip | 36106-1109
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Country | US
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Telephone | 334-293-8696
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Fax |
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Provider Business Mailing Address
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Address Line | 707 FOUNTAIN LN
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City | PRATTVILLE
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State | AL
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Zip | 36067-2860
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Country | US
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Telephone | 334-358-4990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14239
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License Number State | AL
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