Provider Demographics
NPI:1619060555
Name:KINSTON CLINIC PHARMACY INC.
Entity Type:Organization
Organization Name:KINSTON CLINIC PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEMPSEY
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:252-523-3187
Mailing Address - Street 1:701 DOCTORS DR
Mailing Address - Street 2:SUITE P
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1589
Mailing Address - Country:US
Mailing Address - Phone:252-523-3187
Mailing Address - Fax:252-522-2988
Practice Address - Street 1:701 DOCTOR'S DRIVE
Practice Address - Street 2:SUITE P
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501
Practice Address - Country:US
Practice Address - Phone:252-523-3187
Practice Address - Fax:252-522-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC03193333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0545236Medicaid
3413628OtherNABP
3413628OtherNABP