Provider Demographics
NPI:1043931942
Name:MEDDERS, JAMES III (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MEDDERS
Suffix:III
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 1:1625 SIMPSON HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:MAGEE
Mailing Address - State:MS
Mailing Address - Zip Code:39111-4207
Mailing Address - Country:US
Mailing Address - Phone:601-849-3228
Mailing Address - Fax:
Practice Address - Street 1:1625 SIMPSON HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-4207
Practice Address - Country:US
Practice Address - Phone:601-849-3228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD-075071835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care