=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528179348
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | E.W. JAMES & SONS #56
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 02/19/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 690 UNIVERSITY SHOPPING CTR
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40475-2614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-623-3412
-----------------------------------------------------
Fax | 859-623-3365
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 690 UNIVERSITY SHOPPING CTR
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40475-2614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-623-3412
-----------------------------------------------------
Fax | 859-623-3365
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACY MGR
-----------------------------------------------------
Name | MARK S EDWARDS
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 859-623-3412
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PO7000
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------