Healthcare Provider Details

I. General information

NPI: 1508951161
Provider Name (Legal Business Name): ROCKY MOUNT DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 TARBORO ST
ROCKY MOUNT NC
27801-6070
US

IV. Provider business mailing address

1329 TARBORO ST
ROCKY MOUNT NC
27801-6070
US

V. Phone/Fax

Practice location:
  • Phone: 252-446-0014
  • Fax: 252-446-0212
Mailing address:
  • Phone: 252-446-0014
  • Fax: 252-446-0212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number3105
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number3105
License Number StateNC

VIII. Authorized Official

Name: JEAN KITCHIN
Title or Position: CEO
Credential:
Phone: 252-442-5200