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General NPI Number Information
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NPI Number | 1417720632
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Entity Type | Organization
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Legal Business Name | BETHEL PHARMACY, LLC
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Dates
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Enumeration Date | 10/31/2023
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 7433 MAIN STREET
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City | BETHEL
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State | NC
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Zip | 27812
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Country | US
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Telephone | 919-701-6603
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Fax |
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Provider Business Mailing Address
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Address Line | 9650 STRICKLAND RD STE 103-189
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City | RALEIGH
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State | NC
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Zip | 27615-1902
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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 | MANAGER
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Name | CAROLYN MAYO
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Credential |
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Telephone | 919-701-6603
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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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Taxonomy #3
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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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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