Organization
EDEN DRUG INC
Active
Other names
Eden Drug Health Mart
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT L CROUCH R.PH, CPP (PRESIDENT, PHARMACIST)
(336) 627-4854
Entity
Organization
Contact information
Practice address
103 W STADIUM DR, EDEN, NC 27288-3329
(336) 627-4854
(336) 627-8925
Mailing address
103 W STADIUM DR, EDEN, NC 27288-3329
(336) 627-4854
(336) 627-8925
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
09458
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03748
BCBS
NC
01
—
43812
PARTNERS
NC
05
—
7700318
—
NC
05
—
9110968
—
VA
Enumeration date
01/18/2007
Last updated
02/15/2011
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