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General NPI Number Information
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NPI Number | 1255896015
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Entity Type | Organization
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Legal Business Name | ANDERSONS DRUG STORE LLC
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Dates
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Enumeration Date | 02/06/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 206 S. POPLAR ST.
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337
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Country | US
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Telephone | 910-862-8411
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Fax | 910-862-8775
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Provider Business Mailing Address
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Address Line | PO BOX 730
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-0730
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Country | US
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Telephone | 910-862-8411
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Fax | 910-862-8775
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | GENESE ANDERSON PEED
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Credential | PHARM D
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Telephone | 910-862-8411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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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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