Provider Demographics
NPI:1457947418
Name:CALO, JAMES ANDREW
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:CALO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-3029
Mailing Address - Country:US
Mailing Address - Phone:440-602-6071
Mailing Address - Fax:440-942-7129
Practice Address - Street 1:7301 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-3029
Practice Address - Country:US
Practice Address - Phone:440-602-6071
Practice Address - Fax:440-942-7129
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03124518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist