MEDICARE: MEDICAL CENTER PHARMACY 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	03460	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2067892	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770587644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CENTER PHARMACY INC

Provider Business Mailing Address
First Line	:	805 S LONG DR
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4317
Country	:	US
Telephone Number	:	910-997-4471
Fax Number	:	910-997-4951

Provider Business Practice Location Address
First Line	:	805 S LONG DR
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4317
Country	:	US
Telephone Number	:	910-997-4471
Fax Number	:	910-997-4951

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GREGORY A MARKS
Credential	:	RPH
Telephone Number	:	910-997-4471

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	09/02/2022

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