Provider Demographics
NPI:1962743567
Name:TPSRX
Entity type:Organization
Organization Name:TPSRX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:419-843-1370
Mailing Address - Street 1:846 S COY RD
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3452
Mailing Address - Country:US
Mailing Address - Phone:419-693-9459
Mailing Address - Fax:419-843-1362
Practice Address - Street 1:846 S COY RD
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3452
Practice Address - Country:US
Practice Address - Phone:419-693-9459
Practice Address - Fax:419-843-1362
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TPSRX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy