Provider Demographics
NPI:1972682920
Name:JAMES PHARMACY-BARRON LTD
Entity Type:Organization
Organization Name:JAMES PHARMACY-BARRON LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PROHASKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-637-9355
Mailing Address - Street 1:337 E LA SALLE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRON
Mailing Address - State:WI
Mailing Address - Zip Code:54812-1502
Mailing Address - Country:US
Mailing Address - Phone:715-537-5005
Mailing Address - Fax:715-537-5834
Practice Address - Street 1:337 E LA SALLE AVE
Practice Address - Street 2:
Practice Address - City:BARRON
Practice Address - State:WI
Practice Address - Zip Code:54812-1502
Practice Address - Country:US
Practice Address - Phone:715-537-5005
Practice Address - Fax:715-537-5834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6846042332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33083000Medicaid
WI33083000Medicaid