Provider Demographics
NPI:1578873212
Name:FUTRELL, WILLIAM R JR (PHARMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:FUTRELL
Suffix:JR
Gender:M
Credentials:PHARMD
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 768
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NC
Mailing Address - Zip Code:27845-0768
Mailing Address - Country:US
Mailing Address - Phone:252-534-6001
Mailing Address - Fax:252-534-1906
Practice Address - Street 1:9435 NC HIGHWAY 305
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NC
Practice Address - Zip Code:27845-9679
Practice Address - Country:US
Practice Address - Phone:252-534-6001
Practice Address - Fax:252-534-1906
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist