| Organization Name: | CHOCOWINITY PHARMACY, INC |
| NPI Number: | 1154441681 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WALTON P ONEAL, III (PRESIDENT) |
| Mailing Address: | 633 Nc Highway 33 E Chocowinity |
| State: | NC US |
| Postal Code: | 278179005 |
| Phone Number: | 2529464000 |
| Fax Number: | 2529466890 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 07/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |