Provider Demographics
NPI:1619247400
Name:EDDY, JAMES R (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:EDDY
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 1:120 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45692-1435
Mailing Address - Country:US
Mailing Address - Phone:740-384-2174
Mailing Address - Fax:740-384-1685
Practice Address - Street 1:120 W 2ND ST
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OH
Practice Address - Zip Code:45692-1435
Practice Address - Country:US
Practice Address - Phone:740-384-2174
Practice Address - Fax:740-384-1685
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV34681835G0303X
OH32284421835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric