Organization
MITCHENERS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHENER (PRESIDENT)
(252) 487-3711
Entity
Organization
Contact information
Practice address
301 S BROAD ST, EDENTON, NC 27932-1933
(252) 482-3711
(252) 482-7244
Mailing address
PO BOX 6, EDENTON, NC 27932-0006
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
06071
NC
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215012
—
NC
01
—
3405758
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
07/20/2007
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