Healthcare Provider Details

I. General information

NPI: 1932144912
Provider Name (Legal Business Name): VILLAGE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5106 HWY 87 S STE 100
FAYETTEVILLE NC
28306
US

IV. Provider business mailing address

5106 HWY 87 S STE 100
FAYETTEVILLE NC
28306
US

V. Phone/Fax

Practice location:
  • Phone: 910-483-3466
  • Fax: 910-483-0366
Mailing address:
  • Phone: 910-483-3466
  • Fax: 910-483-0366

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 Number09198
License Number StateNC

VIII. Authorized Official

Name: TERRI STORMS
Title or Position: OWNER
Credential: RPH PHARMD
Phone: 910-483-3466