Provider Demographics
NPI:1336795681
Name:WORKIN, JAMES RAYDON (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RAYDON
Last Name:WORKIN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 25TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6171
Mailing Address - Country:US
Mailing Address - Phone:701-293-6022
Mailing Address - Fax:701-293-6040
Practice Address - Street 1:3175 25TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6171
Practice Address - Country:US
Practice Address - Phone:701-293-6022
Practice Address - Fax:701-293-6040
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH6165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist