Organization
NEW MASSEY HILL PHARMACY LLC
Active
Other names
Massey Hill Drug Co.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRIDHAR GOTTIPATI RPH (PHARMACIST OWNER)
(910) 484-0159
Entity
Organization
Contact information
Practice address
1072 SOUTHERN AVE, FAYETTEVILLE, NC 28306-1766
(910) 484-0150
(910) 484-3270
Mailing address
1072 SOUTHERN AVE, FAYETTEVILLE, NC 28306-1766
(910) 484-0150
(910) 484-3270
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10320
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0267534
—
NC
01
—
3406091
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/28/2007
Last updated
08/26/2016
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