Organization
MEBANE DRUG STORE INC
Active
Organization
MEBANE DRUG STORE INC
Active
Other names
Mebane Drug Store, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC BRADY (PRESIDENT/OWNER)
(336) 392-5857
Entity
Organization
Contact information
Practice address
101 E CLAY ST, MEBANE, NC 27302-2434
(919) 304-3784
Mailing address
4918 WARFIELD DR, GREENSBORO, NC 27406-9350
(336) 392-5857
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10313
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3415785
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/29/2009
Last updated
07/14/2009
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