Organization
BLOUNT'S MUTUAL DRUG'S INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES GORDON BLOUNT SR. R.PH. (PRESIDENT)
(252) 482-2127
Entity
Organization
Contact information
Practice address
323 S BROAD ST, EDENTON, NC 27932-1933
(252) 482-2127
Mailing address
323 S BROAD ST, P O BOX 209, EDENTON, NC 27932-1933
(252) 482-2127
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1464
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
1464
NC
3336C0003X
Community/Retail Pharmacy
Primary
01464
NC
335E00000X
Prosthetic/Orthotic Supplier
1464
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215004
—
NC
Enumeration date
09/20/2006
Last updated
12/04/2012
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