Provider Demographics
NPI:1568551372
Name:EW JAMES & SONS, INC, DBA EW JAMES PHARMACY #70
Entity Type:Organization
Organization Name:EW JAMES & SONS, INC, DBA EW JAMES PHARMACY #70
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:731-885-9441
Mailing Address - Street 1:705 E REELFOOT AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5883
Mailing Address - Country:US
Mailing Address - Phone:731-885-9441
Mailing Address - Fax:731-885-4984
Practice Address - Street 1:705 E REELFOOT AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5883
Practice Address - Country:US
Practice Address - Phone:731-885-9441
Practice Address - Fax:731-885-4984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN466332BX2000X
TNRFM00719335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3520707Medicaid
TN3520707Medicaid