Provider Demographics
NPI:1336276609
Name:KING, HAROLD B III (RPH)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:B
Last Name:KING
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28480-0485
Mailing Address - Country:US
Mailing Address - Phone:910-431-5009
Mailing Address - Fax:910-452-7091
Practice Address - Street 1:2231 S COLLEGE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5546
Practice Address - Country:US
Practice Address - Phone:910-452-7098
Practice Address - Fax:910-452-7091
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2800820Medicare ID - Type UnspecifiedINFLUENZA BILLING #