MEDICARE: MJ HOLDINGS OF GREENSBORO LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1205780905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MJ HOLDINGS OF GREENSBORO LLC

Provider Business Mailing Address
First Line	:	6098 MOUNTAIN BROOK RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-8384
Country	:	US
Telephone Number	:	336-944-1365
Fax Number	:

Provider Business Practice Location Address
First Line	:	6098 MOUNTAIN BROOK RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-8384
Country	:	US
Telephone Number	:	336-944-1365
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES BRAXTON
Credential	:	PHARMD
Telephone Number	:	336-944-1365

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	02/21/2026

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