Organization
MAST DRUG CO INC
Active
Other names
Mast Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
POLLY BEAL (ADM MGR)
(252) 438-3112
Entity
Organization
Contact information
Practice address
6000 MEADOWBROOK MALL CT, STE 200, CLEMMONS, NC 27012-8112
(336) 712-0280
(336) 766-7208
Mailing address
1910 ROSS MILL RD, HENDERSON, NC 27537-8789
(252) 438-3112
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
05626
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3430725
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/22/2006
Last updated
12/16/2010
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