Organization
MEDICAL PARK PHARMACY OF ROCKINGHAM INC
Active
Other names
MEDICAL PARK PHARMACY OF ROCKINGHAM
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIS MARKS RPH (OWNER)
(910) 417-3490
Entity
Organization
Contact information
Practice address
921 S LONG DR, STE 105, ROCKINGHAM, NC 28379-4874
(910) 417-3490
(910) 417-3499
Mailing address
921 S LONG DR, STE 105, ROCKINGHAM, NC 28379-4874
(910) 417-3490
(910) 417-3499
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
06891
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0775304
—
NC
01
—
2071711
PK
—
Enumeration date
06/09/2005
Last updated
06/17/2015
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