Provider Demographics
NPI:1962003889
Name:POUNCEY, JOHN R (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:POUNCEY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15017 EMERALD COAST PKWY
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-3358
Mailing Address - Country:US
Mailing Address - Phone:850-654-1502
Mailing Address - Fax:850-654-1785
Practice Address - Street 1:15017 EMERALD COAST PKWY
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-3358
Practice Address - Country:US
Practice Address - Phone:850-654-1502
Practice Address - Fax:850-654-1785
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist