Provider Demographics
NPI:1376354464
Name:GAINEY, PAUL VINCENT III (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:VINCENT
Last Name:GAINEY
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 1:527 OLD MACCUMBER STATION RD APT 325
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-8531
Mailing Address - Country:US
Mailing Address - Phone:472-259-9892
Mailing Address - Fax:
Practice Address - Street 1:4501 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3419
Practice Address - Country:US
Practice Address - Phone:910-799-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12143183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist