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NPI Code Detail

MEDICARE: REALO DISCOUNT DRUG STORES OF EASTERN NORTH CAROLINA INC

MEDICARE: REALO DISCOUNT DRUG STORES OF EASTERN NORTH CAROLINA 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy07031NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
32801191COTHERNCMEDICARE FLU

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22071785OTHERPK

General Provider Information

NPI Number : 1912926023
Entity Type Code : Organization
Provider Name (Legal Business Name) : REALO DISCOUNT DRUG STORES OF EASTERN NORTH CAROLINA INC
Provider Business Mailing Address
First Line : 1301 COMMERCE DR
Second Line :
City : NEW BERN
State : NC
Zip : 28562-2213
Country : US
Telephone Number : 252-636-1711
Fax Number : 252-636-2615
Provider Business Practice Location Address
First Line : 1301 COMMERCE DR
Second Line :
City : NEW BERN
State : NC
Zip : 28562-2213
Country : US
Telephone Number : 252-636-1711
Fax Number : 252-636-2615
Authorized Official
Title or Position : PRES
Name : ROBERT MCLAUGHLIN
Credential : RPH
Telephone Number : 252-636-1711
Provider Enumeration Date : 07/19/2006
Last Update Date : 12/21/2015

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Directions to “REALO DISCOUNT DRUG STORES OF EASTERN NORTH CAROLINA INC ” Practice Location

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