Provider Demographics
NPI:1497943773
Name:WARNER, JAMES R (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:WARNER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 EDMAR ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-2751
Mailing Address - Country:US
Mailing Address - Phone:339-875-2539
Mailing Address - Fax:
Practice Address - Street 1:1637 EDMAR ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-2751
Practice Address - Country:US
Practice Address - Phone:330-875-2539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-07551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist