Provider Demographics
NPI:1427654656
Name:JONES, JAMES EDWARD JR (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:JONES
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:JIMMY
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:114 E CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4300
Mailing Address - Country:US
Mailing Address - Phone:803-775-3020
Mailing Address - Fax:803-774-5010
Practice Address - Street 1:114 E CALHOUN ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4318
Practice Address - Country:US
Practice Address - Phone:803-775-3020
Practice Address - Fax:803-774-5010
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6740183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4214564OtherNABP
SC1861418360OtherNPI
SC720068Medicaid