Provider Demographics
NPI:1417226085
Name:LOHSE, JAMES K (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:K
Last Name:LOHSE
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 1:1112 SW FOREST HILL CV
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2003
Mailing Address - Country:US
Mailing Address - Phone:772-418-0421
Mailing Address - Fax:
Practice Address - Street 1:1112 SW FOREST HILL CV
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2003
Practice Address - Country:US
Practice Address - Phone:772-418-0421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP26541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist