MEDICARE: DILLARD AND ASSOCIATES 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	7811	NC
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3439038	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1841355260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DILLARD AND ASSOCIATES INC

Provider Business Mailing Address
First Line	:	70 CRAPE MYRTLE DR
Second Line	:	SUITE 103
City	:	BENSON
State	:	NC
Zip	:	27504-8034
Country	:	US
Telephone Number	:	919-938-3800
Fax Number	:	919-938-3801

Provider Business Practice Location Address
First Line	:	70 CRAPE MYRTLE DR
Second Line	:	SUITE 103
City	:	BENSON
State	:	NC
Zip	:	27504-8034
Country	:	US
Telephone Number	:	919-938-3800
Fax Number	:	919-938-3801

Authorized Official
Title or Position	:	PHARMACIST
Name	:	JODIE LUMBRAZO
Credential	:	RPH
Telephone Number	:	919-938-3800

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	03/07/2023

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Directions to “DILLARD AND ASSOCIATES INC ” Practice Location

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