Provider Demographics
NPI:1073127510
Name:LA, JAMES MINH KHAI (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MINH KHAI
Last Name:LA
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAINT JAMES AVE
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-2441
Mailing Address - Country:US
Mailing Address - Phone:413-557-1559
Mailing Address - Fax:413-557-1548
Practice Address - Street 1:1 SAINT JAMES AVE
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-2441
Practice Address - Country:US
Practice Address - Phone:413-557-1559
Practice Address - Fax:413-557-1548
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist