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General NPI Number Information
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NPI Number | 1710318274
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Entity Type | Organization
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Legal Business Name | HOMERX HEALTHCARE LLC
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 707 FARRINGDOM ST
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City | LUMBERTON
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State | NC
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Zip | 28358-0007
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Country | US
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Telephone | 910-671-9000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1569
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City | LUMBERTON
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State | NC
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Zip | 28359-1569
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Country | US
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Telephone | 910-671-9000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON FOIL
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Credential |
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Telephone | 910-671-9000
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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 | 11757
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License Number State | NC
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