Healthcare Provider Details

I. General information

NPI: 1225865645
Provider Name (Legal Business Name): MEDICAL CENTER PHARMACY OF ROCKINGHAM INC LTC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 S LONG DR
ROCKINGHAM NC
28379-4317
US

IV. Provider business mailing address

805 S LONG DR
ROCKINGHAM NC
28379-4317
US

V. Phone/Fax

Practice location:
  • Phone: 910-997-4471
  • Fax: 910-997-4951
Mailing address:
  • Phone: 910-997-4471
  • Fax: 910-997-4951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. GREGORY A MARKS
Title or Position: PRESIDENT
Credential: RPH
Phone: 910-997-4471