Provider Demographics
NPI:1275063463
Name:POPE, JIMMIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JIMMIE
Middle Name:
Last Name:POPE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 PHOBOS PL
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6168
Mailing Address - Country:US
Mailing Address - Phone:919-665-9991
Mailing Address - Fax:
Practice Address - Street 1:11911 US 70 BUS HWY W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2144
Practice Address - Country:US
Practice Address - Phone:919-359-2900
Practice Address - Fax:919-359-8277
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist