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General NPI Number Information
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NPI Number | 1972104099
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Entity Type | Individual
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Provider Name | JAMES R HARGIS
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Gender | Male
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 1820 ROSEDALE DR
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City | EDMOND
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State | OK
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Zip | 73013-6638
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Country | US
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Telephone | 405-820-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 7600 NW 23RD ST
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City | BETHANY
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State | OK
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Zip | 73008-4944
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Country | US
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Telephone |
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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 | 10531
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License Number State | OK
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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 | 23771
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License Number State | TX
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