Provider Demographics
NPI:1013699701
Name:JOROS, JAMES BRADFORD (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BRADFORD
Last Name:JOROS
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 1:300 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:WALKERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46574-1246
Mailing Address - Country:US
Mailing Address - Phone:574-586-7154
Mailing Address - Fax:574-586-7039
Practice Address - Street 1:300 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WALKERTON
Practice Address - State:IN
Practice Address - Zip Code:46574-1246
Practice Address - Country:US
Practice Address - Phone:574-586-7154
Practice Address - Fax:574-586-7039
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024826A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist