Provider Demographics
NPI:1376754416
Name:CAPUTO, JAMES BERNARD (RPH, PHARMD)
Entity Type:Individual
Prefix:PROF
First Name:JAMES
Middle Name:BERNARD
Last Name:CAPUTO
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5235 NATALIE CT
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6011
Mailing Address - Country:US
Mailing Address - Phone:814-835-9112
Mailing Address - Fax:814-836-9243
Practice Address - Street 1:5235 NATALIE CT
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-6011
Practice Address - Country:US
Practice Address - Phone:814-835-9112
Practice Address - Fax:814-836-9243
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038141L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP038141LOtherPHARMACY LICENSE