Provider Demographics
NPI:1487996237
Name:FITZGERALD, JAMES MELVIN (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MELVIN
Last Name:FITZGERALD
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 1:1011 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1156
Mailing Address - Country:US
Mailing Address - Phone:804-353-7726
Mailing Address - Fax:804-358-0426
Practice Address - Street 1:1011 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-1156
Practice Address - Country:US
Practice Address - Phone:804-353-7726
Practice Address - Fax:804-358-0426
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist