Healthcare Provider Details

I. General information

NPI: 1417281536
Provider Name (Legal Business Name): CAROLINA APOTHECARY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 06/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 W KINGS HWY SUITE B
EDEN NC
27288-5095
US

IV. Provider business mailing address

PO BOX 29
REIDSVILLE NC
27323-0029
US

V. Phone/Fax

Practice location:
  • Phone: 336-623-3030
  • Fax: 336-623-3031
Mailing address:
  • Phone: 336-342-0071
  • Fax: 336-342-7660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number00129
License Number StateNC

VIII. Authorized Official

Name: MR. CHARLES ARNOLD BRITT
Title or Position: PRESIDENT
Credential: RPH
Phone: 336-394-1100