Organization
FAMILY PHARMACY OF STATESVILLE, INC.
Active
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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