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General NPI Number Information
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NPI Number | 1114395514
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Entity Type | Organization
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Legal Business Name | KINSTON CLINIC PHARMACY INC
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 603 E WASHINGTON ST
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City | LA GRANGE
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State | NC
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Zip | 28551-9214
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Country | US
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Telephone | 252-582-3600
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Fax | 252-582-3503
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Provider Business Mailing Address
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Address Line | 701 DOCTORS DR SUITE P
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City | KINSTON
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State | NC
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Zip | 28501-1589
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Country | US
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Telephone | 252-523-3187
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Fax | 252-522-2988
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Authorized Official
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Title or Position | OWNER/PIC
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Name | DEMPSEY C HILL
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Credential | RPH
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Telephone | 252-523-3187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 12161
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License Number State | NC
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