Johnson Drug Williamsburg Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

08866 Issued in NC

Legal business name

JOHNSON DRUG WILLIAMSBURG INC.

Doing business as

JOHNSON DRUG WILLIAMSBURG

Practice address

2200 Gum Branch Rd
Ste 1
Jacksonville, NC 28540-4574

Phone

(910) 938-0582

Fax

(910) 938-0239

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anthony Medlin

Title

President

Phone

(910) 347-5185

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• JOHNSON DRUG WILLIAMSBURG Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Marie Custis Raynor, PHARM D

  • Pharmacist
  • Atkinson, NC
  • NPI 1346320298
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1336246271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285410250",
            "telephone_number": "910-938-0582",
            "fax_number": "910-938-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GUM BRANCH RD",
            "address_2": "STE 1",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404574",
            "telephone_number": "910-938-0582",
            "fax_number": "910-938-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON DRUG WILLIAMSBURG INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "MEDLIN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-347-5185"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "08866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2072370",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0675595",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHNSON DRUG WILLIAMSBURG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Johnson Drug Co
• Johnson Drug Company Inc
• Johnson Drug Company, Inc
• Johnson Drug Westpark
• Johnson Drug Williamsburg
• Johnson Westpark Drugs
• Jade Angelique Johnson-Grant
• Anishia Johnson
• Dornecia Johnson
• Earlie T Johnson Jr., M.D.

• Community/Retail Pharmacy in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.