Organization
MACK'S 1ST RX PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY N MARLIN (PRESIDENT/OWNER)
(704) 872-0880
Entity
Organization
Contact information
Practice address
8782 NC HWY 90 E, STONY POINT, NC 28678
(704) 585-2102
(704) 585-9440
Mailing address
837 N CENTER ST, STATESVILLE, NC 28677-3222
(704) 872-0880
(704) 871-0440
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5995
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0025148
—
NC
Enumeration date
07/02/2006
Last updated
08/22/2020
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