Provider Demographics
NPI:1396769568
Name:MCHARGUE, JAMES L (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:MCHARGUE
Suffix:
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 1:1125 12TH ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818-2005
Mailing Address - Country:US
Mailing Address - Phone:402-694-3187
Mailing Address - Fax:402-694-6444
Practice Address - Street 1:1125 12TH ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818-2005
Practice Address - Country:US
Practice Address - Phone:402-694-3187
Practice Address - Fax:402-694-6444
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47060594200Medicaid