Provider Demographics
NPI:1295072288
Name:POOLE, JAMES WOODARD JR (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WOODARD
Last Name:POOLE
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-1714
Mailing Address - Country:US
Mailing Address - Phone:800-575-3160
Mailing Address - Fax:877-477-2499
Practice Address - Street 1:507 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-1714
Practice Address - Country:US
Practice Address - Phone:800-575-3160
Practice Address - Fax:877-477-2499
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist