Provider Demographics
NPI:1174860993
Name:J & A MCPHARMACY INC
Entity Type:Organization
Organization Name:J & A MCPHARMACY INC
Other - Org Name:PRICE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUDILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-279-2579
Mailing Address - Street 1:PO BOX 887
Mailing Address - Street 2:
Mailing Address - City:GRANITE QUARRY
Mailing Address - State:NC
Mailing Address - Zip Code:28072-0887
Mailing Address - Country:US
Mailing Address - Phone:704-279-2579
Mailing Address - Fax:704-209-3506
Practice Address - Street 1:110 EAST BANK ST
Practice Address - Street 2:
Practice Address - City:GRANITE QUARRY
Practice Address - State:NC
Practice Address - Zip Code:28072
Practice Address - Country:US
Practice Address - Phone:704-279-2579
Practice Address - Fax:704-209-3506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC114343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2138471OtherPK