Provider Demographics
NPI:1215237292
Name:PHILPOTT, ROYCE JAMES (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:ROYCE
Middle Name:JAMES
Last Name:PHILPOTT
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-2665
Mailing Address - Country:US
Mailing Address - Phone:307-332-3939
Mailing Address - Fax:307-332-3733
Practice Address - Street 1:1165 MAIN ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-2665
Practice Address - Country:US
Practice Address - Phone:307-332-3939
Practice Address - Fax:307-332-3733
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist