Provider Demographics
NPI:1427079219
Name:CREECH, WARREN HARDY II (RPH)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:HARDY
Last Name:CREECH
Suffix:II
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 1:2931 FOX RUN CIR
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-7551
Mailing Address - Country:US
Mailing Address - Phone:252-527-9623
Mailing Address - Fax:252-527-8247
Practice Address - Street 1:300 N QUEEN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4932
Practice Address - Country:US
Practice Address - Phone:252-527-6929
Practice Address - Fax:252-527-8247
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist