Organization
ROCKY MOUNT MEDICAL PARK PHARMACY, INC
Active
Other names
ROCKY MOUNT MEDICAL PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY GORDON CRAWFORD RPH (PRESIDENT)
(252) 443-7979
Entity
Organization
Contact information
Practice address
901 N WINSTEAD AVE, SUITE 100, ROCKY MOUNT, NC 27804-8467
(252) 443-7979
(252) 443-7419
Mailing address
901 N WINSTEAD AVE, SUITE 100, ROCKY MOUNT, NC 27804-8467
(252) 443-7979
(252) 443-7419
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5339
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00335398
—
NC
01
—
3428035
NCPDP
NC
Enumeration date
11/28/2011
Last updated
11/28/2011
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