Provider Demographics
NPI:1902173677
Name:SPRUILL, JAMES D (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:SPRUILL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 PARRIS ISLAND GTWY
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-6921
Mailing Address - Country:US
Mailing Address - Phone:843-524-2300
Mailing Address - Fax:843-524-0915
Practice Address - Street 1:860 PARRIS ISLAND GTWY
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-6921
Practice Address - Country:US
Practice Address - Phone:843-524-2300
Practice Address - Fax:843-524-0915
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-24
Last Update Date:2011-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5452183500000X
KY007801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist