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General NPI Number Information
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NPI Number | 1376091330
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Entity Type | Individual
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Provider Name | JOHN SAMUEL BILLINGSLEY IV
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Gender | Male
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 09/19/2016
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Provider Practice Location Address
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Address Line | 2700 S NC 127 HWY
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City | HICKORY
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State | NC
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Zip | 28602-9130
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Country | US
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Telephone | 828-294-0058
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Fax |
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Provider Business Mailing Address
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Address Line | 1545 LEE PEARSON RD
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City | GRANITE FALLS
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State | NC
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Zip | 28630-9254
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Country | US
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Telephone | 804-836-9370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26493
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License Number State | NC
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