Provider Demographics
NPI:1811212301
Name:SCARBOROUGH, JAMES PERRY SR (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PERRY
Last Name:SCARBOROUGH
Suffix:SR
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 1:106 WINGEDFOOT DR
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-3629
Mailing Address - Country:US
Mailing Address - Phone:334-687-3356
Mailing Address - Fax:
Practice Address - Street 1:106 WINGEDFOOT DR
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-3629
Practice Address - Country:US
Practice Address - Phone:334-687-3356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5221OtherPHARMACY LICENSE