MEDICARE: MR. JAMES EDWARD FAIDLEY JR. R. PH.

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	RP0006715	WV

General Provider Information

NPI Number	:	1821497363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES EDWARD FAIDLEY JR. R. PH.

Provider Business Mailing Address
First Line	:	203 SAMMYS RD
Second Line	:
City	:	COVINGTON
State	:	VA
Zip	:	24426-6004
Country	:	US
Telephone Number	:	540-962-6569
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 SAMMYS RD
Second Line	:
City	:	COVINGTON
State	:	VA
Zip	:	24426-6004
Country	:	US
Telephone Number	:	540-962-6569
Fax Number	:

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

Provider Enumeration Date	:	08/20/2014
Last Update Date	:	04/19/2026

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