Individual
MR. JASON DWIGHT LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH
Contact information
Practice address
2900 N MAIN ST, TARBORO, NC 27886-1921
(252) 823-5655
(252) 823-0412
Mailing address
509 W FRANKLIN ST, ZEBULON, NC 27597-2149
(919) 604-1662
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17246
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17246
BOARD OF PHARMACY LICENSE
NC
Enumeration date
02/23/2012
Last updated
09/16/2024
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