Provider Demographics
NPI:1679606057
Name:MCCORMICK, JAMES PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PAUL
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:63 MAPLE ST.
Mailing Address - Street 2:P.O. BOX 23
Mailing Address - City:MILLMONT
Mailing Address - State:PA
Mailing Address - Zip Code:17845
Mailing Address - Country:US
Mailing Address - Phone:570-922-1467
Mailing Address - Fax:570-372-2526
Practice Address - Street 1:1000 ROUTE 522
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-8707
Practice Address - Country:US
Practice Address - Phone:570-372-5691
Practice Address - Fax:570-372-2526
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031463L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist