Provider Demographics
NPI:1144528266
Name:GIONET, JOHN MARK (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MARK
Last Name:GIONET
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:622 N MARINE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-6142
Mailing Address - Country:US
Mailing Address - Phone:910-455-2911
Mailing Address - Fax:910-937-1802
Practice Address - Street 1:622 N MARINE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-6142
Practice Address - Country:US
Practice Address - Phone:910-455-2911
Practice Address - Fax:910-937-1802
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist