Organization
REALO DISCOUNT DRUG STORES OF GREENE CO., INC
Active
Other names
REALO DISCOUNT DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ROBERT BIZZELL RPH (PRESIDENT)
(252) 527-1081
Entity
Organization
Contact information
Practice address
104 PARKWOOD DR, SNOW HILL, NC 28580-1336
(252) 747-7004
(252) 747-1029
Mailing address
104 PARKWOOD DR, SNOW HILL, NC 28580-1336
(252) 747-7004
(252) 747-1029
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
10514
NC
3336C0003X
Community/Retail Pharmacy
Primary
10514
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0405084
—
NC
05
—
7705264
—
NC
Enumeration date
04/06/2010
Last updated
08/18/2014
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