Provider Demographics
NPI:1427351683
Name:JOHNSON DRUG COMPANY, INC
Entity type:Organization
Organization Name:JOHNSON DRUG COMPANY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MEDLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PPH
Authorized Official - Phone:910-347-5185
Mailing Address - Street 1:1727 SOUTH MADISON STREET
Mailing Address - Street 2:SUITE 11
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-4935
Mailing Address - Country:US
Mailing Address - Phone:910-642-0192
Mailing Address - Fax:910-642-0198
Practice Address - Street 1:1727 SOUTH MADISON STR
Practice Address - Street 2:SUITE 11
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4935
Practice Address - Country:US
Practice Address - Phone:910-642-0192
Practice Address - Fax:910-642-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01720332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies