Provider Demographics
NPI:1457623779
Name:MONK, JAMES BENTON JR (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BENTON
Last Name:MONK
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 1:2000 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-3030
Mailing Address - Country:US
Mailing Address - Phone:478-296-7608
Mailing Address - Fax:478-296-7811
Practice Address - Street 1:2000 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3030
Practice Address - Country:US
Practice Address - Phone:478-296-7608
Practice Address - Fax:478-296-7811
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist