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General NPI Number Information
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NPI Number | 1548288996
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Entity Type | Organization
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Legal Business Name | PHARMACY PLUS OF NEW BERN, INC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 04/16/2010
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Provider Practice Location Address
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Address Line | 1204 S GLENBURNIE RD
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City | NEW BERN
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State | NC
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Zip | 28562-2609
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Country | US
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Telephone | 252-636-3322
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Fax | 252-636-5070
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Provider Business Mailing Address
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Address Line | 658 WHITE HORSE DR
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City | GREENVILLE
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State | NC
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Zip | 27834-7829
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Country | US
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Telephone | 252-752-2363
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Fax | 252-752-0358
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. C STROUD TILLEY III
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Credential | RPH
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Telephone | 252-636-3322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 4747
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License Number State | NC
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