Healthcare Provider Details

I. General information

NPI: 1013025675
Provider Name (Legal Business Name): CREECH DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 01/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 N RAIFORD ST
SELMA NC
27576-2833
US

IV. Provider business mailing address

PO BOX 535
SELMA NC
27576-0535
US

V. Phone/Fax

Practice location:
  • Phone: 919-965-2316
  • Fax: 919-965-2400
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number00640
License Number StateNC

VIII. Authorized Official

Name: CYNTHIA PARRISH
Title or Position: PHCY MGR
Credential:
Phone: 919-965-2316