Individual
JAMES WALDO VANDEVENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
14916 HWY 16 WEST, DEKALB, MS 39328
(601) 743-2917
(601) 743-4455
Mailing address
PO BOX 141, DE KALB, MS 39328-0141
(601) 743-5738
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-07553
MS
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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