Provider Demographics
NPI:1831351329
Name:DOMBACH, JOHN PAUL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:DOMBACH
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 1:600 MOYE BLVD
Mailing Address - Street 2:FPC PHARMACY
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4300
Mailing Address - Country:US
Mailing Address - Phone:252-744-4680
Mailing Address - Fax:252-744-3804
Practice Address - Street 1:600 MOYE BLVD
Practice Address - Street 2:FPC PHARMACY
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-744-4680
Practice Address - Fax:252-744-3804
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist