Provider Demographics
NPI:1376178582
Name:JAMES, KAHLIL A (RPH)
Entity Type:Individual
Prefix:DR
First Name:KAHLIL
Middle Name:A
Last Name:JAMES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:KAHLIL
Other - Middle Name:
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:11376 CAIN OAKS CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-3805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2386 DUNN AVE STE 117
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-4751
Practice Address - Country:US
Practice Address - Phone:904-696-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-08
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60565183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist