Provider Demographics
NPI:1649348509
Name:ALLEN, JOHN PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PAUL
Last Name:ALLEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SOUTHPOINTE RD
Mailing Address - Street 2:
Mailing Address - City:MILL SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:28756-8729
Mailing Address - Country:US
Mailing Address - Phone:828-894-3715
Mailing Address - Fax:
Practice Address - Street 1:756 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3941
Practice Address - Country:US
Practice Address - Phone:828-245-0786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2017-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5661183500000X
PA29904183500000X
NC22993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist