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General NPI Number Information
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NPI Number | 1376965889
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Entity Type | Organization
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Legal Business Name | MAST DRUG CO. INC
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 01/17/2014
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Provider Practice Location Address
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Address Line | 1910 ROSS MILL RD
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City | HENDERSON
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State | NC
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Zip | 27537-8789
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Country | US
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Telephone | 252-438-3112
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Fax | 252-492-4096
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Provider Business Mailing Address
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Address Line | 1910 ROSS MILL RD
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City | HENDERSON
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State | NC
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Zip | 27537-8789
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Country | US
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Telephone | 252-438-3112
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Fax | 252-492-4096
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Authorized Official
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Title or Position | ADM MGR
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Name | MS. POLLY D. BEAL
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Credential |
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Telephone | 252-438-3112
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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 | 05626
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License Number State | NC
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