Provider Demographics
NPI:1760578280
Name:PHILLIPS, JAMES HORACE JR (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HORACE
Last Name:PHILLIPS
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 EDMUND RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170
Mailing Address - Country:US
Mailing Address - Phone:803-755-9600
Mailing Address - Fax:803-755-3271
Practice Address - Street 1:3901 EDMUND RD
Practice Address - Street 2:SUITE D
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29170
Practice Address - Country:US
Practice Address - Phone:803-755-9600
Practice Address - Fax:803-755-3271
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC4787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist