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NPI Code Detail

MEDICARE: MR. JAME3S J CIPOLLA RPH

MEDICARE: MR. JAME3S J CIPOLLA RPH
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
1183500000XPharmacistRPH31291CA

General Provider Information

NPI Number : 1457637050
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAME3S J CIPOLLA RPH
Provider Business Mailing Address
First Line : 475 M ST
Second Line :
City : CRESCENT CITY
State : CA
Zip : 95531-4129
Country : US
Telephone Number : 707-465-3663
Fax Number :
Provider Business Practice Location Address
First Line : 475 M ST
Second Line :
City : CRESCENT CITY
State : CA
Zip : 95531-4129
Country : US
Telephone Number : 707-465-3663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2011
Last Update Date : 10/26/2011

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