Provider Demographics
NPI:1346257318
Name:MEARES, JAMES HUBERT JR (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HUBERT
Last Name:MEARES
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:1089 MAIN ST
Mailing Address - City:FAIR BLUFF
Mailing Address - State:NC
Mailing Address - Zip Code:28439-0346
Mailing Address - Country:US
Mailing Address - Phone:910-649-7555
Mailing Address - Fax:910-649-6424
Practice Address - Street 1:1089 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIR BLUFF
Practice Address - State:NC
Practice Address - Zip Code:28439
Practice Address - Country:US
Practice Address - Phone:910-649-7555
Practice Address - Fax:910-649-6424
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC04846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0245589Medicaid
0645890001Medicare ID - Type Unspecified