Healthcare Provider Details

I. General information

NPI: 1346335494
Provider Name (Legal Business Name): ALMANDS DRUG STORE #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S MAIN STREET
ROCKY MOUNT NC
27802
US

IV. Provider business mailing address

P.O.BOX 311 130 S MAIN STREET
ROCKY MOUNT NC
27802
US

V. Phone/Fax

Practice location:
  • Phone: 252-442-5126
  • Fax: 252-442-8036
Mailing address:
  • Phone: 252-442-5126
  • Fax: 252-442-8036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number01519
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number01519
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number01519
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number01519
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number01519
License Number StateNC

VIII. Authorized Official

Name: MRS. CLAIRE SMITH
Title or Position: PHARMACIST-MANAGER
Credential: R.PH
Phone: 252-442-5126