Provider Demographics
NPI:1184867004
Name:MASON, JAMES BENTON JR (JAMES MASON)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BENTON
Last Name:MASON
Suffix:JR
Gender:M
Credentials:JAMES MASON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 W EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7638
Mailing Address - Country:US
Mailing Address - Phone:330-869-2878
Mailing Address - Fax:
Practice Address - Street 1:1410 W EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7638
Practice Address - Country:US
Practice Address - Phone:330-869-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03317491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist