Provider Demographics
NPI:1942376264
Name:BLOUNT, JAMES G SR (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:G
Last Name:BLOUNT
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:323 S BROAD ST
Mailing Address - Street 2:P O BOX 209
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-1933
Mailing Address - Country:US
Mailing Address - Phone:252-482-2127
Mailing Address - Fax:252-482-5218
Practice Address - Street 1:323 S BROAD ST
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1933
Practice Address - Country:US
Practice Address - Phone:252-482-2127
Practice Address - Fax:252-482-5218
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC4954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist