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General NPI Number Information
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NPI Number | 1104986710
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Entity Type | Organization
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Legal Business Name | REIDSVILLE PHARMACY INC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 924 S SCALES ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-5318
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Country | US
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Telephone | 336-342-9175
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Fax | 336-634-1308
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Provider Business Mailing Address
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Address Line | 924 S SCALES ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-5318
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Country | US
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Telephone | 336-342-9175
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Fax | 336-634-1308
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAMMY COBLE HALL
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Credential | RPH
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Telephone | 336-342-9175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4859
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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