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General NPI Number Information
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NPI Number | 1629590047
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Entity Type | Individual
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Provider Name | JAMES E ERVIN RPH
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Gender | Male
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 07/07/2017
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Provider Practice Location Address
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Address Line | 1310 W MORTON ST
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City | OAKLAND CITY
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State | IN
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Zip | 47660-7615
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Country | US
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Telephone | 812-749-4129
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Fax | 812-749-4561
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Provider Business Mailing Address
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Address Line | 225 PIN OAK LN
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City | MADISONVILLE
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State | KY
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Zip | 42431-8745
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Country | US
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Telephone | 615-480-6575
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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 | 044863
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License Number State | KY
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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 | 013490
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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 | 26025414A
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License Number State | IN
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