Healthcare Provider Details

I. General information

NPI: 1386943785
Provider Name (Legal Business Name): REALO DISCOUNT DRUGS OF ONSLOW, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 01/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 PINEY GREEN RD SUITE 400
JACKSONVILLE NC
28546-8568
US

IV. Provider business mailing address

1301 COMMERCE DR
NEW BERN NC
28562-2213
US

V. Phone/Fax

Practice location:
  • Phone: 910-219-3550
  • Fax: 910-219-3554
Mailing address:
  • Phone: 252-639-9006
  • Fax: 252-639-9005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number6431660002
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number6431660002
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number10988
License Number StateNC

VIII. Authorized Official

Name: MR. ROBERT JOESPH MCLAUGHLIN JR.
Title or Position: PRESIDENT
Credential: RPH
Phone: 252-639-9006