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General NPI Number Information
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NPI Number | 1629134994
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Entity Type | Organization
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Legal Business Name | OBERRY CENTER
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 400 OLD SMITHFIELD RD
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City | GOLDSBORO
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State | NC
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Zip | 27530-8464
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Country | US
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Telephone | 919-581-4686
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Fax | 919-581-4689
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Provider Business Mailing Address
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Address Line | 2021 MAIL SERVICE CTR DHHS CONTROLLERS OFFICE
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City | RALEIGH
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State | NC
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Zip | 27699-2000
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Country | US
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Telephone | 919-581-4686
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Fax | 919-581-4689
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Authorized Official
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Title or Position | PHARM AND MGR
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Name | CARLA DAWSON
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Credential | RPH
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Telephone | 919-581-4686
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 02815
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License Number State | NC
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