Provider Demographics
NPI:1881875839
Name:DREWETT, JAMES G (PHARMD, PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:DREWETT
Suffix:
Gender:M
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E. 17TH ST.
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404
Mailing Address - Country:US
Mailing Address - Phone:208-542-4569
Mailing Address - Fax:513-352-2994
Practice Address - Street 1:535 E. 17TH ST.
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404
Practice Address - Country:US
Practice Address - Phone:208-542-4569
Practice Address - Fax:513-357-7638
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-26424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist