Healthcare Provider Details

I. General information

NPI: 1164560157
Provider Name (Legal Business Name): PUTNAM DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W VIRGINIA AVE
BESSEMER CITY NC
28016-2373
US

IV. Provider business mailing address

PO BOX 27
BESSEMER CITY NC
28016-0027
US

V. Phone/Fax

Practice location:
  • Phone: 704-629-2163
  • Fax: 704-629-6340
Mailing address:
  • Phone: 704-629-3889
  • Fax: 704-629-6340

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 Number7021
License Number StateNC

VIII. Authorized Official

Name: ROBERT PUTNAM
Title or Position: OWNER AND PHARMACIST
Credential: RPH
Phone: 704-629-2163