Organization
DOCTORS PARK PHARMACY INC
Active
Other names
DOCTORS PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY SULLIVAN RPH (PHARMACIST AND MNGR)
(910) 353-5733
Entity
Organization
Contact information
Practice address
403 WESTERN BLVD, JACKSONVILLE, NC 28546-6870
(910) 353-5733
(910) 577-1705
Mailing address
403 WESTERN BLVD, JACKSONVILLE, NC 28546-6870
(910) 353-5733
(910) 577-1705
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
03726
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0675447
—
NC
01
—
3416472
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
7700938
—
NC
Enumeration date
11/21/2006
Last updated
11/16/2012
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