Organization
MEDICAL PARK PHARMACY NEWPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLETCHER JOHNSTON (SECRETARY)
(252) 726-0279
Entity
Organization
Contact information
Practice address
129 NINE FOOT RD, NEWPORT, NC 28570-9251
(252) 223-3080
Mailing address
129 NINE FOOT RD, NEWPORT, NC 28570-9251
(252) 223-3080
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
12156
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12156
NORTH CAROLINA BOARD OF PHARMACY
NC
Enumeration date
04/28/2015
Last updated
04/28/2015
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