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General NPI Number Information
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NPI Number | 1881917730
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Entity Type | Individual
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Provider Name | JAMES EARL MITCHELL JR. R.PH.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2010
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Last Update Date | 03/07/2010
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Provider Practice Location Address
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Address Line | 2721 N VERMILION ST
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City | DANVILLE
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State | IL
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Zip | 61832-1493
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Country | US
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Telephone | 217-443-1514
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Fax | 217-443-1648
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Provider Business Mailing Address
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Address Line | 2721 N VERMILION ST
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City | DANVILLE
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State | IL
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Zip | 61832-1493
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Country | US
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Telephone | 217-443-1514
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Fax | 217-443-1648
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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 | 051-027983
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License Number State | IL
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