Provider Demographics
NPI:1568536670
Name:LONG, JAMES D (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:LONG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:510 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3523
Mailing Address - Country:US
Mailing Address - Phone:205-664-5718
Mailing Address - Fax:
Practice Address - Street 1:1573 CAHABA VALLEY RD
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-3251
Practice Address - Country:US
Practice Address - Phone:205-988-5023
Practice Address - Fax:205-988-5024
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL12250OtherSTATE PHARMACY LICENSE NU