Provider Demographics
NPI:1013699677
Name:PILLION, JACOB RANDALL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:RANDALL
Last Name:PILLION
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 1:3938 AMELIA PARK DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-7406
Mailing Address - Country:US
Mailing Address - Phone:336-328-5660
Mailing Address - Fax:
Practice Address - Street 1:1116 US 70 HWY W
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-2546
Practice Address - Country:US
Practice Address - Phone:919-227-3917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist