Provider Demographics
NPI:1083999221
Name:HIGGINBOTTOM, JAMES LEIGH (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LEIGH
Last Name:HIGGINBOTTOM
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 1:2399 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-4262
Mailing Address - Country:US
Mailing Address - Phone:401-737-5810
Mailing Address - Fax:401-737-5810
Practice Address - Street 1:2399 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-4262
Practice Address - Country:US
Practice Address - Phone:401-737-5810
Practice Address - Fax:401-737-5810
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH03934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist