MEDICARE: SAMANTHA S DRYE PHARM D

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	183500000X	Pharmacist	29318	NC

General Provider Information

NPI Number	:	1285221135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA S DRYE PHARM D

Provider Business Mailing Address
First Line	:	1460 S MAIN ST
Second Line	:
City	:	CHINA GROVE
State	:	NC
Zip	:	28023-8646
Country	:	US
Telephone Number	:	704-855-1316
Fax Number	:	704-857-5028

Provider Business Practice Location Address
First Line	:	1460 S MAIN ST
Second Line	:
City	:	CHINA GROVE
State	:	NC
Zip	:	28023-8646
Country	:	US
Telephone Number	:	704-855-1316
Fax Number	:	704-857-5028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2020
Last Update Date	:	10/18/2022

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