Provider Demographics
NPI:1922310168
Name:GOSS, JAMES WALTER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WALTER
Last Name:GOSS
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 1:10024 MEADOWSTONE DR
Mailing Address - Street 2:
Mailing Address - City:APISON
Mailing Address - State:TN
Mailing Address - Zip Code:37302-7602
Mailing Address - Country:US
Mailing Address - Phone:423-892-2802
Mailing Address - Fax:
Practice Address - Street 1:5564 LITTLE DEBBIE PKWY STE 102
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4356
Practice Address - Country:US
Practice Address - Phone:423-521-7279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000029425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist