Provider Demographics
NPI:1164695060
Name:RATHKE, JAMES WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:RATHKE
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:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:ORBISONIA
Mailing Address - State:PA
Mailing Address - Zip Code:17243-0367
Mailing Address - Country:US
Mailing Address - Phone:814-447-3934
Mailing Address - Fax:814-447-3757
Practice Address - Street 1:626 WATER ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ORBISONIA
Practice Address - State:PA
Practice Address - Zip Code:17243
Practice Address - Country:US
Practice Address - Phone:814-447-3934
Practice Address - Fax:814-447-3757
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031410L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist