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NPI 1689433153

NPI 1689433153 : JAMES ROBERT DUKEMINIER : UNION GROVE, AL

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General NPI Number Information
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    NPI Number           |    1689433153
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES ROBERT DUKEMINIER
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/18/2024
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    Last Update Date     |    03/18/2024
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Provider Practice Location Address
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    Address Line         |    468 CRISCOE RD 
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    City                 |    UNION GROVE
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    State                |    AL
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    Zip                  |    35175-5104
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    Country              |    US
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    Telephone            |    256-843-9095
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    468 CRISCOE RD 
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    City                 |    UNION GROVE
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    State                |    AL
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    Zip                  |    35175-5104
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    Country              |    US
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    Telephone            |    256-843-9095
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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       |    23441
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    License Number State |    AL
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