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NPI Code Detail

MEDICARE: DR. JADE-ANNA KING PHARMD

MEDICARE:  DR. JADE-ANNA  KING  PHARMD
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
1183500000XPharmacist29005NC

General Provider Information

NPI Number : 1578194957
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JADE-ANNA KING PHARMD
Provider Business Mailing Address
First Line : 2965 WAYCROSS ROAD
Second Line :
City : MAGNOLIA
State : NC
Zip : 28453
Country : US
Telephone Number : 919-805-5210
Fax Number :
Provider Business Practice Location Address
First Line : 134 LIBERTY SQ STE B
Second Line :
City : KENANSVILLE
State : NC
Zip : 28349-8602
Country : US
Telephone Number : 910-296-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2020
Last Update Date : 04/03/2020

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Directions to “ DR. JADE-ANNA KING PHARMD” Practice Location

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