Provider Demographics
NPI:1386246510
Name:DE JAMES, JOHN RAYMOND (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RAYMOND
Last Name:DE JAMES
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 1:521 LELAND DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-2758
Mailing Address - Country:US
Mailing Address - Phone:412-304-7998
Mailing Address - Fax:
Practice Address - Street 1:521 LELAND DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-2758
Practice Address - Country:US
Practice Address - Phone:412-304-7998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035907L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist