MEDICARE: KERR DRUG INC A DELAWARE COMPANY

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	333600000X	Pharmacy	6962	NC
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3434355	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881704583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KERR DRUG INC A DELAWARE COMPANY

Provider Business Mailing Address
First Line	:	3649 NEW BERN AVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-1232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3649 NEW BERN AVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-1232
Country	:	US
Telephone Number	:	919-231-8716
Fax Number	:	919-231-8152

Authorized Official
Title or Position	:	PHARMACIST MANAGER
Name	:	DEBBIE DEMPSEY
Credential	:	RPH
Telephone Number	:	919-231-8716

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	09/11/2025

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