Provider Demographics
NPI:1467700468
Name:JAMES, JERICKA (PHARMD)
Entity Type:Individual
Prefix:
First Name:JERICKA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 W BELL RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3806
Mailing Address - Country:US
Mailing Address - Phone:623-979-4484
Mailing Address - Fax:
Practice Address - Street 1:8055 W BELL RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3806
Practice Address - Country:US
Practice Address - Phone:623-979-4484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist