Provider Demographics
NPI:1740609569
Name:CORDAN, JAMES (PHMARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:CORDAN
Suffix:
Gender:M
Credentials:PHMARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 SCOTTS HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-8973
Mailing Address - Country:US
Mailing Address - Phone:803-467-4350
Mailing Address - Fax:803-781-7810
Practice Address - Street 1:1180 DUTCH FORK RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8874
Practice Address - Country:US
Practice Address - Phone:803-781-7877
Practice Address - Fax:803-781-7810
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist