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General NPI Number Information
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NPI Number | 1184711020
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Entity Type | Organization
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Legal Business Name | MITCHELL'S DISCOUNT DRUGS, INC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 641 WASHINGTON ST
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City | EDEN
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State | NC
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Zip | 27288-6137
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Country | US
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Telephone | 336-623-3136
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Fax | 336-623-2218
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Provider Business Mailing Address
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Address Line | 641 WASHINGTON ST
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City | EDEN
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State | NC
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Zip | 27288-6137
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Country | US
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Telephone | 336-623-3136
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Fax | 336-623-2218
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Authorized Official
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Title or Position | SECRETARY OF CORPORATION
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Name | SUSAN M TALLEY
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Credential |
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Telephone | 336-623-7747
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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 | 2447
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License Number State | NC
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