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General NPI Number Information
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NPI Number | 1457461238
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Entity Type | Organization
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Legal Business Name | WARSAW RX LLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 103 S DUDLEY ST
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City | BURGAW
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State | NC
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Zip | 28425-5539
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Country | US
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Telephone | 910-259-2116
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Fax | 910-259-7298
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Provider Business Mailing Address
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Address Line | PO BOX 295
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City | RICHLANDS
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State | NC
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Zip | 28574-0295
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Country | US
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Telephone | 252-943-8688
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | KELSEY GELDERMAN
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Credential |
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Telephone | 252-943-8688
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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 | 12939
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License Number State | NC
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