Basic Information
| Provider Information | |||||||||
| NPI: | 1003141938 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | DURWOOD | ||||||||
| MiddleName: | RAY | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | B. S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2802 FAIRFAX ROAD | ||||||||
| Address2: | |||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285041153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525221378 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2201 NORTH HERRITAGE STREET | ||||||||
| Address2: | |||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525224902 | ||||||||
| FaxNumber: | 2522081365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2009 | ||||||||
| LastUpdateDate: | 10/09/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 06277 | NC | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.