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General NPI Number Information
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NPI Number | 1083942361
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Entity Type | Individual
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Provider Name | JAMES ALDEN HATHCOCK JR. R.PH.
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Gender | Male
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 1209 N BRIDGE ST
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City | ELKIN
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State | NC
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Zip | 28621-2301
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Country | US
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Telephone | 336-526-0011
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Fax | 336-526-6005
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Provider Business Mailing Address
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Address Line | 1209 N BRIDGE ST
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City | ELKIN
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State | NC
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Zip | 28621-2301
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Country | US
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Telephone | 336-526-0011
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Fax | 336-526-6005
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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 | 04523
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202006239
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License Number State | VA
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