Healthcare Provider Details

I. General information

NPI: 1134234172
Provider Name (Legal Business Name): WARD DRUG COMPANY OF NASHVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 W CHURCH ST
NASHVILLE NC
27856-1327
US

IV. Provider business mailing address

PO BOX 400
NASHVILLE NC
27856-0400
US

V. Phone/Fax

Practice location:
  • Phone: 252-459-2135
  • Fax: 252-459-5029
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number04645
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GARY GLISSON
Title or Position: OWNER PHCST
Credential:
Phone: 252-459-2135