Provider Demographics
NPI:1467789230
Name:PILCONIS, JOHN PETER (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PETER
Last Name:PILCONIS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 VILLAGE SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8077
Mailing Address - Country:US
Mailing Address - Phone:336-905-7175
Mailing Address - Fax:
Practice Address - Street 1:3711 VILLAGE SPRINGS DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8077
Practice Address - Country:US
Practice Address - Phone:336-905-7175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-15
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist