Organization
MAYBERRY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALLACE ALLEN JOHNSON JR. (OWNER)
(336) 789-0424
Entity
Organization
Contact information
Practice address
933 OLD ROCKFORD ST, SUITE 3, MOUNT AIRY, NC 27030-5356
(336) 789-0424
(336) 789-0157
Mailing address
933 OLD ROCKFORD ST, SUITE 3, MOUNT AIRY, NC 27030-5356
(336) 789-0424
(336) 789-0157
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
08125
NC
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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