Provider Demographics
NPI:1346532058
Name:ROBERTS, JAMES E (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:ROBERTS
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 1:5870 WEBSTER RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-9105
Mailing Address - Country:US
Mailing Address - Phone:304-872-4394
Mailing Address - Fax:304-872-5783
Practice Address - Street 1:5870 WEBSTER RD
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-9105
Practice Address - Country:US
Practice Address - Phone:304-872-4394
Practice Address - Fax:304-872-5783
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist