Organization
GKB INC.
Active
Other names
JEFFERSON DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG KEITH BOWER RPH (OWNER)
(336) 246-9492
Entity
Organization
Contact information
Practice address
418 E MAIN ST, JEFFERSON, NC 28640-0155
(336) 246-9492
(336) 846-9177
Mailing address
PO BOX 155, 418 E MAIN ST, JEFFERSON, NC 28640-0155
(336) 246-9492
(336) 846-9177
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7700417
—
NC
Enumeration date
08/08/2006
Last updated
11/15/2007
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