Provider Demographics
NPI:1568715506
Name:FURGURSON, ERNEST III (RPH)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:
Last Name:FURGURSON
Suffix:III
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 1:1901 N CROATAN HWY
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-8978
Mailing Address - Country:US
Mailing Address - Phone:252-441-2001
Mailing Address - Fax:252-449-0320
Practice Address - Street 1:1901 N CROATAN HWY
Practice Address - Street 2:
Practice Address - City:KILL DEVIL HILLS
Practice Address - State:NC
Practice Address - Zip Code:27948-8978
Practice Address - Country:US
Practice Address - Phone:252-441-2001
Practice Address - Fax:252-449-0320
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist