Provider Demographics
NPI:1326152547
Name:WILLIFORD, JOEY W (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOEY
Middle Name:W
Last Name:WILLIFORD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 OLD GOLDSBORO RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28366-7759
Mailing Address - Country:US
Mailing Address - Phone:910-594-1183
Mailing Address - Fax:910-594-1130
Practice Address - Street 1:305 WEEKS CIRCLE
Practice Address - Street 2:
Practice Address - City:NEWTON GROVE
Practice Address - State:NC
Practice Address - Zip Code:28366
Practice Address - Country:US
Practice Address - Phone:910-594-1183
Practice Address - Fax:910-594-1130
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist