Healthcare Provider Details

I. General information

NPI: 1609942366
Provider Name (Legal Business Name): MAST DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 WEST BLVD
WILLIAMSTON NC
27892-2145
US

IV. Provider business mailing address

805 S GARNETT ST
HENDERSON NC
27536
US

V. Phone/Fax

Practice location:
  • Phone: 252-792-1015
  • Fax: 252-792-2174
Mailing address:
  • Phone: 252-438-3112
  • Fax: 252-492-4096

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 Number03766
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICHARD I FLYE JR.
Title or Position: PRESIDENT
Credential:
Phone: 252-438-3112