Provider Demographics
NPI:1679041842
Name:NEALEY, PHILLIP TREY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:TREY
Last Name:NEALEY
Suffix:
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 1:83 MAHAN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-8924
Mailing Address - Country:US
Mailing Address - Phone:910-640-7179
Mailing Address - Fax:
Practice Address - Street 1:200 COLUMBUS CORNERS DR
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4905
Practice Address - Country:US
Practice Address - Phone:910-640-1893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC282333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy