Provider Demographics
NPI:1295735835
Name:GOROSPE, JAMES KEVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEVIN
Last Name:GOROSPE
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 1:10036 DEER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-4315
Mailing Address - Country:US
Mailing Address - Phone:916-833-5058
Mailing Address - Fax:916-426-4284
Practice Address - Street 1:10036 DEER RIDGE DR
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4315
Practice Address - Country:US
Practice Address - Phone:916-833-5058
Practice Address - Fax:916-626-4284
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH37695183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist