Provider Demographics
NPI:1750944351
Name:PHILLIPS, JAMES THOMAS
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:PHILLIPS
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 1:6675 BUSINESS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-3603
Mailing Address - Country:US
Mailing Address - Phone:303-683-4179
Mailing Address - Fax:
Practice Address - Street 1:6675 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-3603
Practice Address - Country:US
Practice Address - Phone:303-683-4179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist