Organization
FOSTER DRUG OF MOCKSVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS BEAM (MANAGING MEMBER)
(336) 751-2141
Entity
Organization
Contact information
Practice address
495 VALLEY RD, MOCKSVILLE, NC 27028-2074
(336) 751-2141
(336) 751-7974
Mailing address
495 VALLEY RD, MOCKSVILLE, NC 27028-2074
(336) 751-2141
(336) 751-7974
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386700268
—
NC
01
—
2067876
PK
—
Enumeration date
12/28/2006
Last updated
07/14/2020
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