Organization
EDEN DRUG, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CROUCH (PHARMACIST)
(336) 627-4854
Entity
Organization
Contact information
Practice address
103 W STADIUM DR, EDEN, NC 27288-3329
(336) 627-4854
Mailing address
103 W STADIUM DR, EDEN, NC 27288-3329
(336) 627-4854
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0795443
—
NC
Enumeration date
03/18/2020
Last updated
04/15/2020
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