Healthcare Provider Details

I. General information

NPI: 1043200363
Provider Name (Legal Business Name): PHARMAX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N PATTERSON ST
MAXTON NC
28364-1735
US

IV. Provider business mailing address

102 N PATTERSON ST
MAXTON NC
28364-1735
US

V. Phone/Fax

Practice location:
  • Phone: 910-844-3100
  • Fax: 910-844-3017
Mailing address:
  • Phone: 910-844-3100
  • Fax: 910-844-3017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07800
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number07800
License Number StateNC

VIII. Authorized Official

Name: DAVID S HESTER
Title or Position: RPH/OWNER
Credential:
Phone: 910-844-3100