Provider Demographics
NPI:1265434278
Name:NORMARK, JAMES W (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:NORMARK
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:PO BOX 1123
Mailing Address - Street 2:264 PEACEMAKER PLACE
Mailing Address - City:SEELEY LAKE
Mailing Address - State:MT
Mailing Address - Zip Code:59868-1123
Mailing Address - Country:US
Mailing Address - Phone:406-210-2471
Mailing Address - Fax:
Practice Address - Street 1:264 PEACEMAKER PL
Practice Address - Street 2:
Practice Address - City:SEELEY LAKE
Practice Address - State:MT
Practice Address - Zip Code:59868-1123
Practice Address - Country:US
Practice Address - Phone:406-210-2471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5649183500000X
ND3258183500000X
MT6954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist