Organization
GO PHARMACY INC
Active
Other names
Go Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRENTON BYRD (CEO)
(910) 398-5467
Entity
Organization
Contact information
Practice address
203 CHAUNCEY TOWN RD STE B, LAKE WACCAMAW, NC 28450-2003
(910) 646-6614
(910) 646-6615
Mailing address
PO BOX 479, LAKE WACCAMAW, NC 28450-0479
(910) 646-6614
(910) 646-6615
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
11191
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0245886
—
NC
01
—
2117971
PK
—
05
—
7705424
—
NC
Enumeration date
07/02/2008
Last updated
11/06/2013
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