Provider Demographics
NPI:1346510971
Name:O'GRADY, JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:O'GRADY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 GRANDVIEW CT
Mailing Address - Street 2:APT 400
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-3208
Mailing Address - Country:US
Mailing Address - Phone:319-430-8062
Mailing Address - Fax:
Practice Address - Street 1:3100 11TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-6706
Practice Address - Country:US
Practice Address - Phone:309-786-4312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-293972183500000X
IA21155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist