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General NPI Number Information
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NPI Number | 1689397572
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Entity Type | Individual
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Provider Name | JOSEPH TIMOTHY MARTINEZ PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 1501 W CUMBERLAND ST
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City | DUNN
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State | NC
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Zip | 28334-4505
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Country | US
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Telephone | 910-891-1930
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Fax |
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Provider Business Mailing Address
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Address Line | 616 SMITHRIDGE WAY
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-2577
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Country | US
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Telephone | 505-480-5739
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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 | 31712
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License Number State | NC
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