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General NPI Number Information
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NPI Number | 1417040841
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Entity Type | Organization
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Legal Business Name | OVERMAN & STEVENSON PHARMACY
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Dates
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Enumeration Date | 09/30/2006
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 512 E MAIN ST
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-4430
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Country | US
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Telephone | 252-335-5401
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Fax | 252-335-5402
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Provider Business Mailing Address
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Address Line | 512 E MAIN ST
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-4430
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Country | US
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Telephone | 252-335-5401
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Fax | 252-335-5402
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Authorized Official
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Title or Position | PHRMCST AND PARTNER
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Name | NICHOLAS STEVENSON
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Credential |
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Telephone | 252-335-5401
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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 | 00219
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License Number State | NC
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