Provider Demographics
NPI:1124034046
Name:MCPHAILS PHARMACY INC
Entity type:Organization
Organization Name:MCPHAILS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:910-893-4544
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:815 W FRONT ST
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546
Mailing Address - Country:US
Mailing Address - Phone:910-893-4544
Mailing Address - Fax:910-814-2396
Practice Address - Street 1:815 W FRONT ST
Practice Address - Street 2:MCPHAILS PHARMACY INC
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546
Practice Address - Country:US
Practice Address - Phone:910-897-7165
Practice Address - Fax:910-897-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC052633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0435347Medicaid
NC0435347Medicaid