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General NPI Number Information
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NPI Number | 1588774285
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Entity Type | Organization
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Legal Business Name | KERR DRUG INC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 2190 LAWNDALE DR
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City | GREENSBORO
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State | NC
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Zip | 27408-7102
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Country | US
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Telephone | 336-379-1053
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Fax | 336-379-7885
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Provider Business Mailing Address
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Address Line | 3220 SPRING FOREST RD
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City | RALEIGH
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State | NC
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Zip | 27616-2822
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Country | US
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Telephone | 919-544-3896
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Fax | 919-544-7719
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Authorized Official
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Title or Position | VP OF PHARMACY
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Name | MARK GREGORY
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Credential | RPH
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Telephone | 919-544-3896
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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 | 7251
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License Number State | NC
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