MEDICARE: THE DRUG STORE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy	12913	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2069115	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285670174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DRUG STORE INC

Provider Business Mailing Address
First Line	:	3064 SALEM INDUSTRIAL DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-8854
Country	:	US
Telephone Number	:	336-831-0500
Fax Number	:	855-760-7126

Provider Business Practice Location Address
First Line	:	3064 SALEM INDUSTRIAL DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-8854
Country	:	US
Telephone Number	:	336-831-0500
Fax Number	:	855-760-7126

Authorized Official
Title or Position	:	EXECUTIVE MANAGER
Name	:	DARRELL HOLLAND
Credential	:
Telephone Number	:	888-729-0729

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	05/09/2016

Similar Medicare Providers

1013999689 — MS. MARY C THOMAS RPH, CGP, FSACP
Practice Location Address:

3064 SALEM INDUSTRIAL DR
WINSTON SALEM, NC
27127-8854

Practice Phone: 336-831-0500
Practice Fax:

1194666826 — ALICIA TARRANT RN
Practice Location Address:

2936 EDWARDS ST
WINSTON SALEM, NC
27127-3919

Practice Phone: 336-473-7250
Practice Fax:

1740121474 — SENIOR RETREAT DAY CENTER LLC
Practice Location Address:

2936 EDWARDS ST
WINSTON SALEM, NC
27127-3919

Practice Phone: 336-473-7250
Practice Fax:

1417899428 — RILEY HALL
Practice Location Address:

905 FRIEDBERG CHURCH RD
WINSTON SALEM, NC
27127-9803

Practice Phone: 336-251-1180
Practice Fax:

1700888492 — DR. JOHN MICHAEL BURKE O.D.
Practice Location Address:

2630 PETERS CREEK PKWY
WINSTON-SALEM, NC
27127-5655

Practice Phone: 336-785-3486
Practice Fax: 336-785-3002

1306839659 — WALTER AZUBUIKE EZEIGBO MD
Practice Location Address:

1000 SOUTHPARK BLVD , SUITE A
WINSTON SALEM, NC
27127-5072

Practice Phone: 336-788-4545
Practice Fax: 336-788-4556

Directions to “THE DRUG STORE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.