Provider Demographics
NPI:1902908700
Name:ACREE, JAMES A (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:ACREE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14 HIBISCIS LN
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-6941
Mailing Address - Country:US
Mailing Address - Phone:573-822-6575
Mailing Address - Fax:217-222-1065
Practice Address - Street 1:1723 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2838
Practice Address - Country:US
Practice Address - Phone:217-222-0792
Practice Address - Fax:217-222-1065
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005041202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist