Provider Demographics
NPI:1821373986
Name:LABERGE, JAMES OSCAR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:OSCAR
Last Name:LABERGE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-1147
Mailing Address - Country:US
Mailing Address - Phone:218-721-2113
Mailing Address - Fax:
Practice Address - Street 1:2015 TOWER AVE
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-2538
Practice Address - Country:US
Practice Address - Phone:715-392-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16179-040183500000X
MN120185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist