Provider Demographics
NPI:1760431506
Name:FLETCHER, JAMES EDWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:FLETCHER
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 1:1965 HIGHWAY 41 S
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-8642
Mailing Address - Country:US
Mailing Address - Phone:478-994-5576
Mailing Address - Fax:
Practice Address - Street 1:173 N LEE ST
Practice Address - Street 2:CVS PHARMACY
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-2123
Practice Address - Country:US
Practice Address - Phone:478-994-0193
Practice Address - Fax:478-994-6914
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist