Provider Demographics
NPI:1043341316
Name:HESS, JAMES B (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:B
Last Name:HESS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:480 SW SUMMERHILL GLN
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32024-0823
Mailing Address - Country:US
Mailing Address - Phone:386-754-7380
Mailing Address - Fax:386-754-6431
Practice Address - Street 1:619 S MARION AVE
Practice Address - Street 2:ROOM 62-124
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-5808
Practice Address - Country:US
Practice Address - Phone:386-754-7380
Practice Address - Fax:386-754-6431
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 24563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist