MEDICARE: JAMES EDWARD FRAZIER II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202007778	VA

General Provider Information

NPI Number	:	1336132216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES EDWARD FRAZIER II

Provider Business Mailing Address
First Line	:	3243 CLIFF AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23222-2755
Country	:	US
Telephone Number	:	804-649-8765
Fax Number	:	804-649-8766

Provider Business Practice Location Address
First Line	:	1510 N 28TH ST
Second Line	:	SUITE 100
City	:	RICHMOND
State	:	VA
Zip	:	23223-5332
Country	:	US
Telephone Number	:	804-649-8765
Fax Number	:	804-649-8766

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	07/08/2007

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Directions to “ JAMES EDWARD FRAZIER II ” Practice Location

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