Organization
DERMATOLOGY ASSOCIATES PA
Active
Other names
Dermatology Associates Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TONY GURLEY (PHARMACY MANAGER)
(919) 215-0240
Entity
Organization
Contact information
Practice address
1904 TRADD CT, WILMINGTON, NC 28401-6637
(919) 865-4641
Mailing address
PO BOX 90216, RALEIGH, NC 27675-0216
(919) 865-4641
(919) 865-4644
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
11215
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3459903
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/29/2012
Last updated
03/29/2012
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