=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124378567
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES ALAN COUNTS RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2012
-----------------------------------------------------
Last Update Date | 09/25/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 712 BYPASS 25 NE
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29646-3030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-229-1957
-----------------------------------------------------
Fax | 864-229-2326
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 712 BYPASS 25 NE
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29646-3030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-229-1957
-----------------------------------------------------
Fax | 864-229-2326
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 4464
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------