Provider Demographics
NPI:1295013217
Name:FEEHAN, JAMES CLINTON (RP031430L)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CLINTON
Last Name:FEEHAN
Suffix:
Gender:M
Credentials:RP031430L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WESLEND AVE
Mailing Address - Street 2:
Mailing Address - City:SWEET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18656-2311
Mailing Address - Country:US
Mailing Address - Phone:570-477-6019
Mailing Address - Fax:
Practice Address - Street 1:600 HUNTER HWY
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-7984
Practice Address - Country:US
Practice Address - Phone:570-836-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP0314340L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist