Healthcare Provider Details

I. General information

NPI: 1477995165
Provider Name (Legal Business Name): CALDWELL DISCOUNT DRUG COMPANY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 MAIN STREET
HUDSON NC
28638
US

IV. Provider business mailing address

425 MAIN STREET
HUDSON NC
28638
US

V. Phone/Fax

Practice location:
  • Phone: 828-728-3561
  • Fax:
Mailing address:
  • Phone: 828-728-3561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN W HAYES
Title or Position: PHARMACIST/OWNER
Credential: PHARM.D.
Phone: 828-292-4294