Organization
NORTHSIDE FAMILY PLAZA PHARMACY INC
Active
Other names
NORTHSIDE FAMILY PHARMACY AT THE PLAZA
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA STOKES (PRES)
(252) 985-4263
Entity
Organization
Contact information
Practice address
1041 NOELL LN, STE 102, ROCKY MOUNT, NC 27804-2058
(252) 985-4265
(252) 985-4287
Mailing address
3920 BISHOP RD, BATTLEBORO, NC 27809-9038
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
09327
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0645491
—
NC
01
—
3406130
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/10/2006
Last updated
08/27/2009
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