Provider Demographics
NPI:1942294079
Name:JAMES C. STOKES
Entity Type:Organization
Organization Name:JAMES C. STOKES
Other - Org Name:BOWEN DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-625-2840
Mailing Address - Street 1:118 S COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:COLEMAN
Mailing Address - State:TX
Mailing Address - Zip Code:76834-4210
Mailing Address - Country:US
Mailing Address - Phone:325-625-2840
Mailing Address - Fax:325-625-4138
Practice Address - Street 1:118 S COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:COLEMAN
Practice Address - State:TX
Practice Address - Zip Code:76834-4210
Practice Address - Country:US
Practice Address - Phone:325-625-2840
Practice Address - Fax:325-625-4138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-03
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110428Medicaid
4515980OtherNABP