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General NPI Number Information
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NPI Number | 1538145610
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Entity Type | Organization
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Legal Business Name | FAMILY PHARMACY OF STATESVILLE, INC.
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 3478 E BROAD ST
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City | STATESVILLE
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State | NC
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Zip | 28625-4523
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Country | US
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Telephone | 704-872-0296
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Fax | 704-883-5856
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Provider Business Mailing Address
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Address Line | 3478 E BROAD ST
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City | STATESVILLE
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State | NC
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Zip | 28625-4523
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Country | US
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Telephone | 704-872-0296
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Fax | 704-883-5856
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA EUDY
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Credential | BS
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Telephone | 704-872-0296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 04383
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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