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NPI Code Detail

MEDICARE: MEDICAL PARK PHARMACY GREENVILLE

MEDICARE: MEDICAL PARK PHARMACY GREENVILLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy09288NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22065833OTHERPK

General Provider Information

NPI Number : 1699720441
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL PARK PHARMACY GREENVILLE
Provider Business Mailing Address
First Line : 1872 W ARLINGTON BLVD
Second Line : STE M
City : GREENVILLE
State : NC
Zip : 27834-5704
Country : US
Telephone Number : 252-321-0222
Fax Number : 252-321-0508
Provider Business Practice Location Address
First Line : 1872 W ARLINGTON BLVD
Second Line : STE M
City : GREENVILLE
State : NC
Zip : 27834-5704
Country : US
Telephone Number : 252-321-0222
Fax Number : 252-321-0508
Authorized Official
Title or Position : VICE PRESIDENT
Name : STEPHEN WICHER
Credential :
Telephone Number : 252-726-0777
Provider Enumeration Date : 05/23/2006
Last Update Date : 01/20/2017

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Directions to “MEDICAL PARK PHARMACY GREENVILLE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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