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NPI Code Detail

MEDICARE: KERR DRUG INC

MEDICARE: KERR DRUG 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy6502NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23433199OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1942310636
Entity Type Code : Organization
Provider Name (Legal Business Name) : KERR DRUG INC
Provider Business Mailing Address
First Line : 3220 SPRING FOREST RD
Second Line :
City : RALEIGH
State : NC
Zip : 27616-2822
Country : US
Telephone Number : 919-544-3896
Fax Number : 919-544-7719
Provider Business Practice Location Address
First Line : 116 W DEPOT ST
Second Line :
City : ANGIER
State : NC
Zip : 27501-6696
Country : US
Telephone Number : 919-639-2910
Fax Number : 919-639-3079
Authorized Official
Title or Position : VP OF PHARMACY
Name : MARK GREGORY
Credential : RPH
Telephone Number : 919-544-3896
Provider Enumeration Date : 08/30/2006
Last Update Date : 01/04/2012

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Directions to “KERR DRUG INC ” Practice Location

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