Provider Demographics
NPI:1548567613
Name:RIDDLE, JAMES H (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:RIDDLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4380 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:BEECH ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29842-4864
Mailing Address - Country:US
Mailing Address - Phone:803-593-5506
Mailing Address - Fax:803-593-8210
Practice Address - Street 1:4380 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:BEECH ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29842-4864
Practice Address - Country:US
Practice Address - Phone:803-593-5506
Practice Address - Fax:803-593-8210
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist