Organization
DOROTHEA DIX HOSPITAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINGER UPDEGRAVE RPH (DIRECTOR OF PHARMACY)
(919) 733-5266
Entity
Organization
Contact information
Practice address
820 S BOYLAN AVE, RALEIGH, NC 27603-2246
(919) 733-5266
(919) 733-1544
Mailing address
CENTRAL BILLING OFFICE DHHS CONTROLLERS OFFICE, 2021 MAIL SERVICE CENTER, RALEIGH, NC 27699-0001
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
02600
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3409922
OTHER ID NUMBER
—
05
—
344001
—
NC
Enumeration date
01/04/2007
Last updated
04/15/2008
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