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Organization

STOKESDALE FAMILY PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JIMMY DALE KEITH JR. RPH MBA (PRESIDENT)
(336) 595-6979
Entity
Organization

Contact information

Practice address
8500 US HIGHWAY 158, STOKESDALE, NC 27357-9248
(336) 644-7288
(336) 644-7291
Mailing address
8500 US HIGHWAY 158, STOKESDALE, NC 27357-9248
(336) 644-7288
(336) 644-7291

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
10378
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1174859722
NPI
NC
Enumeration date
04/14/2010
Last updated
05/12/2010
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