Organization
PUNGO RIVER PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT ELLIS (OWNER)
(252) 943-2585
Entity
Organization
Contact information
Practice address
892 US HIGHWAY 264 BYP, BELHAVEN, NC 27810-9771
(252) 943-2585
(252) 943-3076
Mailing address
892 US HIGHWAY 264 BYP, BELHAVEN, NC 27810-9771
(252) 943-2585
(252) 943-3076
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7700043
—
NC
Enumeration date
01/31/2007
Last updated
09/19/2011
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