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General NPI Number Information
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NPI Number | 1528209137
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Entity Type | Organization
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Legal Business Name | COSTWISE PHARMACY INC
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 712 WASHINGTON ST
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City | WILLIAMSTON
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State | NC
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Zip | 27892-2648
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Country | US
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Telephone | 252-809-4288
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Fax | 252-809-4287
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Provider Business Mailing Address
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Address Line | 275 PAMLICO ST
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City | BELHAVEN
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State | NC
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Zip | 27810-1417
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Country | US
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Telephone | 252-943-1913
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Fax | 252-944-2828
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Authorized Official
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Title or Position | PRESIDENT
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Name | WALTON O'NEAL
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Credential |
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Telephone | 252-943-1913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 10253
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License Number State | NC
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