Organization
GO PHARMACY INC
Active
Other names
GO RX
Organization subpart
No
Provider details
NPI number
Authorized official
BRENTON BYRD (CEO)
(910) 398-5467
Entity
Organization
Contact information
Practice address
1911 S 17TH ST STE 100, WILMINGTON, NC 28401-6663
(910) 646-3112
(910) 646-1126
Mailing address
PO BOX 479, LAKE WACCAMAW, NC 28450-0479
(910) 646-3112
(910) 646-1126
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
11203
NC
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0245902
—
NC
01
—
2133087
PK
—
Enumeration date
04/09/2009
Last updated
08/28/2013
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