Provider Demographics
NPI:1194273060
Name:FOX, JAMES IV (PHARMD, CGP, RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:FOX
Suffix:IV
Gender:M
Credentials:PHARMD, CGP, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2546 E 2ND ST
Mailing Address - Street 2:STE 100
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-2062
Mailing Address - Country:US
Mailing Address - Phone:307-472-0597
Mailing Address - Fax:
Practice Address - Street 1:2546 E 2ND ST
Practice Address - Street 2:STE 100
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-2062
Practice Address - Country:US
Practice Address - Phone:307-472-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist