MEDICARE: WARD DRUG COMPANY OF NASHVILLE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	04645	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	3424556	OTHER	NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134234172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARD DRUG COMPANY OF NASHVILLE INC

Provider Business Mailing Address
First Line	:	PO BOX 400
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-0400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 W CHURCH ST
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-1327
Country	:	US
Telephone Number	:	252-459-2135
Fax Number	:	252-459-5029

Authorized Official
Title or Position	:	OWNER PHCST
Name	:	GARY GLISSON
Credential	:
Telephone Number	:	252-459-2135

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	03/26/2013

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Directions to “WARD DRUG COMPANY OF NASHVILLE INC ” Practice Location

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