Provider Demographics
NPI:1104289503
Name:JANIK, LAUREN (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:JANIK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-9674
Mailing Address - Country:US
Mailing Address - Phone:252-559-1121
Mailing Address - Fax:252-559-1381
Practice Address - Street 1:4003 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-9674
Practice Address - Country:US
Practice Address - Phone:252-559-1121
Practice Address - Fax:252-559-1381
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC101355098Medicaid
NC101355098Medicaid
NCP00400633Medicare PIN
NC0282938475Medicare NSC