Provider Demographics
NPI:1225384464
Name:MCCONNELL, JAMES MARTIN (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MARTIN
Last Name:MCCONNELL
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 1:138 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-8460
Mailing Address - Country:US
Mailing Address - Phone:814-696-5219
Mailing Address - Fax:
Practice Address - Street 1:138 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8460
Practice Address - Country:US
Practice Address - Phone:814-696-5219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP 035714 L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist