Organization
RSB FAIRCLOTH INC
Active
Other names
HealthKeeperz Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE FAIRCLOTH (PRESIDENT/OWNER)
(910) 522-1041
Entity
Organization
Contact information
Practice address
812 CANDY PARK RD, PEMBROKE, NC 28372-9129
(910) 522-1041
(910) 522-1085
Mailing address
PO BOX 2760, PEMBROKE, NC 28372-2760
(910) 522-1041
(910) 522-1085
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
12625
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152644
PK
—
Enumeration date
06/15/2015
Last updated
07/21/2015
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