Healthcare Provider Details

I. General information

NPI: 1164785796
Provider Name (Legal Business Name): ZOO CITY DRUG, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 SHAMROCK RD
ASHEBORO NC
27203-6947
US

IV. Provider business mailing address

600 W ACADEMY ST
RANDLEMAN NC
27317-9748
US

V. Phone/Fax

Practice location:
  • Phone: 336-626-3784
  • Fax:
Mailing address:
  • Phone: 336-495-5100
  • Fax: 336-495-5300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number11271
License Number StateNC

VIII. Authorized Official

Name: MICHAEL GRIFFIN
Title or Position: PRESIDENT
Credential:
Phone: 336-495-5100