Jonathan Stuart Graham, PHARMD
Individual provider Active NPI Pharmacist · King, NC
NPI 1265815666 · NPPES record last updated Oct 14, 2016
Key facts
- NPI
- 1265815666
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 25244 (NC)
- Practice address
- 450 S. Main St
King, NC 27021-9016 - Phone
- (336) 414-9672
- NPI assigned
- Jul 2, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25244 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 25244 | NC | Yes |
Addresses
Primary practice location
450 S. Main St
King, NC 27021-9016
Mailing address
450 S. Main St
King, NC 27021-9016
Phone (336) 414-9672
Other providers in King, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.