Provider Demographics
NPI:1215544713
Name:ATKINS, JAMES RONALD (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RONALD
Last Name:ATKINS
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 374
Mailing Address - Street 2:
Mailing Address - City:CHARLTON HEIGHTS
Mailing Address - State:WV
Mailing Address - Zip Code:25040-0374
Mailing Address - Country:US
Mailing Address - Phone:304-206-0801
Mailing Address - Fax:
Practice Address - Street 1:1414 N EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3124
Practice Address - Country:US
Practice Address - Phone:304-255-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist