Provider Demographics
NPI:1215152194
Name:SUAREZ, JAMES C (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 5TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-1623
Mailing Address - Country:US
Mailing Address - Phone:828-465-1977
Mailing Address - Fax:
Practice Address - Street 1:815 FAIRGROVE CHURCH RD SE
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8609
Practice Address - Country:US
Practice Address - Phone:828-322-4505
Practice Address - Fax:828-322-2669
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC5566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC5566OtherPHARMACIST LICENSE NUMBER