Provider Demographics
NPI:1043209299
Name:ROE, JAMES ALLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLEN
Last Name:ROE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 12TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST JAMES
Mailing Address - State:MN
Mailing Address - Zip Code:56081-2031
Mailing Address - Country:US
Mailing Address - Phone:507-375-3557
Mailing Address - Fax:
Practice Address - Street 1:923 6TH AVE
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-2703
Practice Address - Country:US
Practice Address - Phone:507-372-7371
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1178355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist