Provider Demographics
NPI:1033212402
Name:GREEN, JAMES CHRISTOPHER (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:GREEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 RAY MEARS BLVD
Mailing Address - Street 2:TARGET PHARMACY T-0151
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5457
Mailing Address - Country:US
Mailing Address - Phone:865-560-1550
Mailing Address - Fax:
Practice Address - Street 1:8040 RAY MEARS BLVD
Practice Address - Street 2:TARGET PHARMACY T-0151
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5457
Practice Address - Country:US
Practice Address - Phone:865-560-1550
Practice Address - Fax:865-560-1550
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13520183500000X
TN0000028945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist