Provider Demographics
NPI:1558642090
Name:PRUES, JAMES EDWARD JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:PRUES
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9150 KINGS CROSSING RD
Mailing Address - Street 2:PHARMACY
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-0848
Mailing Address - Country:US
Mailing Address - Phone:239-284-1702
Mailing Address - Fax:239-561-4626
Practice Address - Street 1:9150 KINGS CROSSING RD
Practice Address - Street 2:PHARMACY
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-0848
Practice Address - Country:US
Practice Address - Phone:239-284-1702
Practice Address - Fax:239-561-4626
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist