Healthcare Provider Details

I. General information

NPI: 1831209535
Provider Name (Legal Business Name): KERR DRUG INC A DELAWARE COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 MARTIN LUTHER KING DR
MAXTON NC
28364
US

IV. Provider business mailing address

106 MARTIN LUTHER KING DR
MAXTON NC
28364
US

V. Phone/Fax

Practice location:
  • Phone: 910-844-3096
  • Fax: 910-844-3116
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number6927
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAN LOCKLEAR
Title or Position: PHARMACIST MANAGER
Credential: RPH
Phone: 910-844-3096