Provider Demographics
NPI:1598758526
Name:WHITEHEAD, JAMES RICHARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:WHITEHEAD
Suffix:
Gender:M
Credentials:PHARMD
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Mailing Address - Street 1:1200 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:HOME CARE PHARMACY
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7659
Mailing Address - Country:US
Mailing Address - Phone:770-844-3339
Mailing Address - Fax:770-844-3397
Practice Address - Street 1:1200 NORTHSIDE FORSYTH DR
Practice Address - Street 2:HOME CARE PHARMACY
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7659
Practice Address - Country:US
Practice Address - Phone:770-844-3339
Practice Address - Fax:770-844-3397
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARPH014209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH014209OtherPHARMACY LICENSE