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General NPI Number Information
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NPI Number | 1285676882
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Entity Type | Organization
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Legal Business Name | ELLERBE PHARMACY
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 274 SECOND STREET
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City | ELLERBE
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State | NC
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Zip | 28338
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Country | US
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Telephone | 910-652-6261
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Fax | 910-652-2469
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Provider Business Mailing Address
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Address Line | PO BOX 467
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City | ELLERBE
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State | NC
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Zip | 28338-0467
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER-MANAGER
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Name | RODNEY MCCASKILL
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Credential | RPH
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Telephone | 910-652-6261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 11846
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License Number State | NC
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