Provider Demographics
NPI:1215263603
Name:VINSON, JOSEPH STEPHEN (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:STEPHEN
Last Name:VINSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W GANNON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-2623
Mailing Address - Country:US
Mailing Address - Phone:919-269-3323
Mailing Address - Fax:919-269-5401
Practice Address - Street 1:101 W GANNON AVE
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-2623
Practice Address - Country:US
Practice Address - Phone:919-269-3323
Practice Address - Fax:919-269-5401
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist