Organization
HARRIS PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TED GILBERT GUPTON (PRESIDENT)
(919) 496-3543
Entity
Organization
Contact information
Practice address
105 N MAIN ST, LOUISBURG, NC 27549-2570
(919) 496-3543
(919) 496-9989
Mailing address
105 N MAIN ST, LOUISBURG, NC 27549-2570
(919) 496-3543
(919) 496-9989
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
05191
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
05191
NC
3336C0003X
Community/Retail Pharmacy
Primary
05191
NC
335E00000X
Prosthetic/Orthotic Supplier
05191
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0316X
BLUE CROSS BLUE SHIELD
NC
05
—
0355016
—
NC
Enumeration date
02/08/2007
Last updated
08/07/2007
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