Provider Demographics
NPI:1164527479
Name:E.W. JAMES & SONS
Entity Type:Organization
Organization Name:E.W. JAMES & SONS
Other - Org Name:EW JAMES PHARMACY 74
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:731-885-9441
Mailing Address - Street 1:1308-14 NAILING DRIVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-1928
Mailing Address - Country:US
Mailing Address - Phone:731-885-0601
Mailing Address - Fax:731-885-9334
Practice Address - Street 1:5024 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-3196
Practice Address - Country:US
Practice Address - Phone:731-686-7411
Practice Address - Fax:731-686-2166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4420270Medicaid