Provider Demographics
NPI:1346644747
Name:RAINS, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:RAINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6643 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-1715
Mailing Address - Country:US
Mailing Address - Phone:770-942-4982
Mailing Address - Fax:678-838-1808
Practice Address - Street 1:6643 CHURCH ST
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-1715
Practice Address - Country:US
Practice Address - Phone:770-942-4982
Practice Address - Fax:678-838-1808
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist