Provider Demographics
NPI:1053627299
Name:CALCAVECCHIA, JAMES ALTON (BS-PHARMACY)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALTON
Last Name:CALCAVECCHIA
Suffix:
Gender:M
Credentials:BS-PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2686
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76902-2686
Mailing Address - Country:US
Mailing Address - Phone:325-947-3677
Mailing Address - Fax:325-947-5827
Practice Address - Street 1:3328 SHERWOOD WAY
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3529
Practice Address - Country:US
Practice Address - Phone:325-947-3677
Practice Address - Fax:325-947-5827
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist