Provider Demographics
NPI:1699798843
Name:MASON, ROY KINSMAN JR (RPH)
Entity type:Individual
Prefix:MR
First Name:ROY
Middle Name:KINSMAN
Last Name:MASON
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 160013
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-0002
Mailing Address - Country:US
Mailing Address - Phone:864-578-8742
Mailing Address - Fax:864-578-5450
Practice Address - Street 1:2510 BOILING SPRINGS RD
Practice Address - Street 2:UNIT A
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-5385
Practice Address - Country:US
Practice Address - Phone:864-578-0155
Practice Address - Fax:864-578-8268
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist