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NPI 1578148631

NPI 1578148631 : JOHN W PHILLIPS : MOREHEAD CITY, NC

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General NPI Number Information
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    NPI Number           |    1578148631
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN W PHILLIPS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/10/2021
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    Last Update Date     |    03/10/2021
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Provider Practice Location Address
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    Address Line         |    5008 HWY 70 WEST 
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    City                 |    MOREHEAD CITY
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    State                |    NC
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    Zip                  |    28557
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    Country              |    US
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    Telephone            |    800-275-8777
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5008 HWY 70 WEST 
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    City                 |    MOREHEAD CITY
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    State                |    NC
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    Zip                  |    28557
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    Country              |    US
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    Telephone            |    800-275-8777
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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       |    7375
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    License Number State |    NC
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