Healthcare Provider Details

I. General information

NPI: 1902508740
Provider Name (Legal Business Name): HOGAN'S PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/17/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 W FRONT ST
LILLINGTON NC
27546-9735
US

IV. Provider business mailing address

PO BOX 159
LILLINGTON NC
27546-0159
US

V. Phone/Fax

Practice location:
  • Phone: 910-893-4544
  • Fax: 910-893-4544
Mailing address:
  • Phone: 910-893-4544
  • Fax: 910-893-4544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: STACIE HOGAN
Title or Position: PRESIDENT
Credential:
Phone: 910-893-4544