Provider Demographics
NPI:1609295716
Name:JOHNSTON COUNTY PHARMACIES INC
Entity Type:Organization
Organization Name:JOHNSTON COUNTY PHARMACIES INC
Other - Org Name:REALO DISCOUNT DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEQUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHAMD
Authorized Official - Phone:919-980-4031
Mailing Address - Street 1:601 N 8TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4119
Mailing Address - Country:US
Mailing Address - Phone:919-934-2111
Mailing Address - Fax:919-934-2814
Practice Address - Street 1:6030 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:FOUR OAKS
Practice Address - State:NC
Practice Address - Zip Code:27524
Practice Address - Country:US
Practice Address - Phone:919-980-4031
Practice Address - Fax:919-980-4032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC119863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy