Provider Demographics
NPI:1306063581
Name:GILLESPIE, JAMES CLEMENT (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CLEMENT
Last Name:GILLESPIE
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 1:3630 MCCREARY RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2212
Mailing Address - Country:US
Mailing Address - Phone:814-836-9941
Mailing Address - Fax:
Practice Address - Street 1:4145 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16510-2109
Practice Address - Country:US
Practice Address - Phone:814-899-6924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033555L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist