Provider Demographics
NPI:1528179348
Name:E.W. JAMES & SONS #56
Entity Type:Organization
Organization Name:E.W. JAMES & SONS #56
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MGR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:859-623-3412
Mailing Address - Street 1:690 UNIVERSITY SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2614
Mailing Address - Country:US
Mailing Address - Phone:859-623-3412
Mailing Address - Fax:859-623-3365
Practice Address - Street 1:690 UNIVERSITY SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2614
Practice Address - Country:US
Practice Address - Phone:859-623-3412
Practice Address - Fax:859-623-3365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:E.W. JAMES & SONS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPO70003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54008867Medicaid
KY1828740OtherNCPDP
KY90009663Medicaid
1230620013Medicare NSC