Healthcare Provider Details
I. General information
NPI: 1053326686
Provider Name (Legal Business Name): TART AND WEST DRUGGISTS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 ROSEBORO ST
ROSEBORO NC
28382
US
IV. Provider business mailing address
PO BOX 250
ROSEBORO NC
28382-0250
US
V. Phone/Fax
- Phone: 910-525-5333
- Fax: 910-525-4862
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | 00609 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
WEST
Title or Position: OWNER
Credential: RPH
Phone: 910-525-5734