MEDICARE: FLETCHER JOHNSTON PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	14910	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14910	OTHER	NC	NCBOP

General Provider Information

NPI Number	:	1053601948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLETCHER JOHNSTON PHARM D

Provider Business Mailing Address
First Line	:	278 HWY 24
Second Line	:	SUITE M
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2582
Country	:	US
Telephone Number	:	252-726-0279
Fax Number	:

Provider Business Practice Location Address
First Line	:	278 HWY 24
Second Line	:	SUITE M
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2582
Country	:	US
Telephone Number	:	252-726-0279
Fax Number	:	252-726-0792

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2011
Last Update Date	:	03/04/2017

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