Organization
FAMILY PHARMACY OF STATESVILLE, INC.
Active
Other names
ProvidenceRx, FAMILY PHARMACY OF STATESVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA EUDY BS (CEO)
(704) 872-0296
Entity
Organization
Contact information
Practice address
3478 E BROAD ST, STATESVILLE, NC 28625-4523
(704) 872-0296
(704) 883-5856
Mailing address
3478 E BROAD ST, STATESVILLE, NC 28625-4523
(704) 872-0296
(704) 883-5856
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
04383
NC
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0495390
—
NC
01
—
2069161
PK
—
Enumeration date
12/20/2005
Last updated
03/06/2025
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