=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073893541
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES P. ANDERSON RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2011
-----------------------------------------------------
Last Update Date | 12/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 555 N MAIZE RD
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67212-4655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-729-6171
-----------------------------------------------------
Fax | 316-729-0639
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 555 N MAIZE RD
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67212-4655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-729-6171
-----------------------------------------------------
Fax | 316-729-0639
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 1-09861
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------