Provider Demographics
NPI:1336029180
Name:DOCTORS PARK PHARMACY INC
Entity type:Organization
Organization Name:DOCTORS PARK PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST MANAGER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JARMAN
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:910-353-5733
Mailing Address - Street 1:403 WESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6399
Mailing Address - Country:US
Mailing Address - Phone:910-353-5733
Mailing Address - Fax:800-776-2220
Practice Address - Street 1:403 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6399
Practice Address - Country:US
Practice Address - Phone:910-353-5733
Practice Address - Fax:800-776-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy