Provider Demographics
NPI:1811361454
Name:PRESTON, JAMES JR (PHARMD,BCPS,RPHWMTS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:PRESTON
Suffix:JR
Gender:M
Credentials:PHARMD,BCPS,RPHWMTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N. GRAND VLVD
Mailing Address - Street 2:PHARMACY DEPT., JOHN COCHRAN VA MEDICAL CENTER
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63106
Mailing Address - Country:US
Mailing Address - Phone:314-330-3562
Mailing Address - Fax:
Practice Address - Street 1:915 N. GRAND VLVD
Practice Address - Street 2:PHARMACY DEPT., JOHN COCHRAN VA MEDICAL CENTER
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106
Practice Address - Country:US
Practice Address - Phone:314-330-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0415121835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA17043OtherRPH
IL294160OtherRPH
MO041512OtherRPH W/MTS
DC294160OtherBCPS