Provider Demographics
NPI:1972878775
Name:JAMES, JACQUELINE JAVOR (PHARMD)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:JAVOR
Last Name:JAMES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 GROWDENVALE DR NE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6844
Mailing Address - Country:US
Mailing Address - Phone:301-697-9407
Mailing Address - Fax:
Practice Address - Street 1:3 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1058
Practice Address - Country:US
Practice Address - Phone:301-777-1773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist