Provider Demographics
NPI:1588914162
Name:IVEY, JAMES OLIVER JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:OLIVER
Last Name:IVEY
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6129 CALHOUN MEMORIAL HWY STE C
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3781
Mailing Address - Country:US
Mailing Address - Phone:864-849-4077
Mailing Address - Fax:864-859-6608
Practice Address - Street 1:6129 CALHOUN MEMORIAL HWY STE C
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3781
Practice Address - Country:US
Practice Address - Phone:864-849-4077
Practice Address - Fax:864-859-6608
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist