Provider Demographics
NPI:1205173812
Name:FOSTER, JAMES RALPH I (R PH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RALPH
Last Name:FOSTER
Suffix:I
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 N INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-2944
Mailing Address - Country:US
Mailing Address - Phone:941-473-3301
Mailing Address - Fax:
Practice Address - Street 1:55 N INDIANA AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-2944
Practice Address - Country:US
Practice Address - Phone:941-473-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist