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General NPI Number Information
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NPI Number | 1376354464
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Entity Type | Individual
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Provider Name | PAUL VINCENT GAINEY III R.PH.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 4501 MARKET ST
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City | WILMINGTON
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State | NC
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Zip | 28405-3419
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Country | US
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Telephone | 910-799-0448
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Fax |
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Provider Business Mailing Address
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Address Line | 527 OLD MACCUMBER STATION RD APT 325
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City | WILMINGTON
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State | NC
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Zip | 28405-8531
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Country | US
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Telephone | 472-259-9892
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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 | 12143
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License Number State | NC
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