=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063524379
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES DUNAWAY R.PH.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 3RD ST
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42420-2993
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-826-6565
-----------------------------------------------------
Fax | 270-830-0083
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13023 CRESTWOOD CT
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42420-9108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-826-0337
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 7646
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------