Healthcare Provider Details

I. General information

NPI: 1992788020
Provider Name (Legal Business Name): JA MCNEILL & SONS & DAUGHTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 06/24/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 TRAM RD
WHITEVILLE NC
28472-3520
US

IV. Provider business mailing address

PO BOX 2189
WHITEVILLE NC
28472-7189
US

V. Phone/Fax

Practice location:
  • Phone: 910-642-0388
  • Fax: 866-642-1152
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number07711
License Number StateNC

VIII. Authorized Official

Name: JOHN A MCNEILL JR.
Title or Position: OWNER
Credential:
Phone: 910-815-3122