Provider Demographics
NPI:1912224098
Name:GENTRY, JAMES PHILLIPS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILLIPS
Last Name:GENTRY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:AL
Mailing Address - Zip Code:36925-2008
Mailing Address - Country:US
Mailing Address - Phone:205-392-5201
Mailing Address - Fax:205-392-7006
Practice Address - Street 1:583 4TH AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:AL
Practice Address - Zip Code:36925-2008
Practice Address - Country:US
Practice Address - Phone:205-392-5201
Practice Address - Fax:205-392-7006
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist