Provider Demographics
NPI:1407582729
Name:PIONEER APCO LLC
Entity Type:Organization
Organization Name:PIONEER APCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:336-509-5751
Mailing Address - Street 1:1100 REVOLUTION MILL DR STE 10
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5067
Mailing Address - Country:US
Mailing Address - Phone:336-285-7985
Mailing Address - Fax:336-617-0781
Practice Address - Street 1:723 S VAN BUREN RD STE A
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5321
Practice Address - Country:US
Practice Address - Phone:336-285-7985
Practice Address - Fax:336-617-0781
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPSTREAM CARE COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy