=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619060845
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FUTRELL PHARMACY SERVICE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2006
-----------------------------------------------------
Last Update Date | 05/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 124 S MAIN ST
-----------------------------------------------------
City | RICH SQUARE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27869
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-539-2552
-----------------------------------------------------
Fax | 252-539-4205
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 547
-----------------------------------------------------
City | RICH SQUARE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27869-0547
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-539-2552
-----------------------------------------------------
Fax | 252-539-4205
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER AND PHARMACIST
-----------------------------------------------------
Name | WILLIAM FUTRELL JR.
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 252-534-6001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 09355
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------