Provider Demographics
NPI:1427468677
Name:MAHONEY, JANET (RPH)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 NORTH CROATAN HIGHWAY
Mailing Address - Street 2:WAL-MART 2000
Mailing Address - City:KITTY HAWK
Mailing Address - State:NC
Mailing Address - Zip Code:27949
Mailing Address - Country:US
Mailing Address - Phone:252-261-3310
Mailing Address - Fax:252-261-0746
Practice Address - Street 1:5400 N CROATAN HWY
Practice Address - Street 2:
Practice Address - City:KITTY HAWK
Practice Address - State:NC
Practice Address - Zip Code:27949-3877
Practice Address - Country:US
Practice Address - Phone:252-261-3310
Practice Address - Fax:252-261-0746
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist