Provider Demographics
NPI:1073622577
Name:MYHRE, JOHN H (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:MYHRE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4163
Mailing Address - Country:US
Mailing Address - Phone:919-772-5514
Mailing Address - Fax:919-772-5514
Practice Address - Street 1:3601 MAIL SERVICE CTR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27699-3601
Practice Address - Country:US
Practice Address - Phone:919-733-5266
Practice Address - Fax:919-733-1544
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47501835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric