Provider Demographics
NPI:1578605382
Name:LINGENFELTER, JAMES LAMAR (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LAMAR
Last Name:LINGENFELTER
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 1:153 LAKE LURE DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:GA
Mailing Address - Zip Code:31510-1503
Mailing Address - Country:US
Mailing Address - Phone:912-310-0096
Mailing Address - Fax:
Practice Address - Street 1:153 LAKE LURE DR
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:GA
Practice Address - Zip Code:31510-1503
Practice Address - Country:US
Practice Address - Phone:912-310-0096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist