Healthcare Provider Details

I. General information

NPI: 1669687810
Provider Name (Legal Business Name): UNITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 THREE HUNTS DR UNIT E
PEMBROKE NC
28372-7318
US

IV. Provider business mailing address

PO BOX 450
PEMBROKE NC
28372-0450
US

V. Phone/Fax

Practice location:
  • Phone: 910-521-7481
  • Fax: 910-521-7482
Mailing address:
  • Phone: 910-521-7481
  • Fax: 910-521-7482

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 TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number10144
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOMAS ENNIS
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 910-521-7481