Organization
WOMBLE DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LUNDY (PRESIDENT)
(252) 793-9036
Entity
Organization
Contact information
Practice address
454 HWY 64 EAST, PLYMOUTH, NC 27962
(252) 793-9036
(252) 793-1006
Mailing address
PO BOX 99, PLYMOUTH, NC 27962-0099
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10413
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0945014
—
NC
01
—
3409819
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/21/2006
Last updated
02/25/2015
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