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General NPI Number Information
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NPI Number | 1417160326
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Entity Type | Individual
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Provider Name | JAMES WICOFF R.PH.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 05/22/2014
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Provider Practice Location Address
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Address Line | 2826 PRAIRIE ST
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City | EMPORIA
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State | KS
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Zip | 66801-5922
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Country | US
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Telephone | 620-412-4850
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Fax |
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Provider Business Mailing Address
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Address Line | 2826 PRAIRIE ST
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City | EMPORIA
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State | KS
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Zip | 66801-5922
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Country | US
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Telephone | 620-412-4850
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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 | 1-11147
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License Number State | KS
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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 | 040375
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.028636
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License Number State | IL
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