Provider Demographics
NPI:1649308016
Name:MCKINNEY, JAMES L (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:MCKINNEY
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:ST. CLAIR CIRCLE
Mailing Address - Street 2:5523 - THE OAKS
Mailing Address - City:MOODY
Mailing Address - State:AL
Mailing Address - Zip Code:35004
Mailing Address - Country:US
Mailing Address - Phone:205-640-6347
Mailing Address - Fax:
Practice Address - Street 1:465 MAIN STREET
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173
Practice Address - Country:US
Practice Address - Phone:205-661-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist