Provider Demographics
NPI:1023355963
Name:WOLFROM, JAMES TODD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TODD
Last Name:WOLFROM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3921
Mailing Address - Country:US
Mailing Address - Phone:850-747-9787
Mailing Address - Fax:850-747-3260
Practice Address - Street 1:650 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3921
Practice Address - Country:US
Practice Address - Phone:850-747-9787
Practice Address - Fax:850-747-3260
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0028747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist