Provider Demographics
NPI:1669898862
Name:HARDY, WILLIAM BURNICE IV (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BURNICE
Last Name:HARDY
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4101 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-9672
Mailing Address - Country:US
Mailing Address - Phone:252-527-8400
Mailing Address - Fax:252-208-0109
Practice Address - Street 1:3801 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8618
Practice Address - Country:US
Practice Address - Phone:252-917-6865
Practice Address - Fax:252-917-6870
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20575183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist