Organization
TODDS NORTHSIDE PROFESSIONAL PCHY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL TWIFORD (PRES)
(252) 331-1333
Entity
Organization
Contact information
Practice address
1141 N ROAD ST, STE A1, ELIZABETH CITY, NC 27909-3354
(252) 331-1333
(252) 331-1911
Mailing address
PO BOX 1448, ELIZABETH CITY, NC 27906-1448
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
333600000X
Pharmacy
05351
NC
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0155036
—
NC
01
—
3428174
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/12/2006
Last updated
09/11/2025
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