Healthcare Provider Details

I. General information

NPI: 1679499453
Provider Name (Legal Business Name): SENTRY DRUG CENTER 4 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 FALLSTON RD
FALLSTON NC
28042
US

IV. Provider business mailing address

5011 FALLSTON RD
FALLSTON NC
28042
US

V. Phone/Fax

Practice location:
  • Phone: 704-538-3021
  • Fax: 704-538-0224
Mailing address:
  • Phone: 704-538-3021
  • Fax: 704-538-0224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TODD EUGENE PIGG
Title or Position: RPH/OWNER
Credential:
Phone: 704-735-2551