Provider Demographics
NPI:1861088957
Name:CASTLEMAN, JAMES RICHARD
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:CASTLEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BASKETT RD
Mailing Address - Street 2:
Mailing Address - City:LIMESTONE
Mailing Address - State:TN
Mailing Address - Zip Code:37681-2203
Mailing Address - Country:US
Mailing Address - Phone:423-444-6380
Mailing Address - Fax:
Practice Address - Street 1:4209 NORTH ROAN STREET
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-282-5722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC7131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist