Provider Demographics
NPI:1124303839
Name:JAMES, ANGELIA D (RPH)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:D
Last Name:JAMES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8018 NORMANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-6647
Mailing Address - Country:US
Mailing Address - Phone:904-271-4140
Mailing Address - Fax:904-781-8744
Practice Address - Street 1:8018 NORMANDY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-6647
Practice Address - Country:US
Practice Address - Phone:904-271-4140
Practice Address - Fax:904-781-8744
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS21304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist