Organization
FUQUAY DRUG CO INC
Active
Other names
ELLIOTTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS HOLLEMAN (PHARMACIST OWNER)
(919) 552-2277
Entity
Organization
Contact information
Practice address
202 S MAIN ST, FUQUAY VARINA, NC 27526-2259
(919) 552-2277
(919) 557-0274
Mailing address
202 S MAIN ST, FUQUAY VARINA, NC 27526-2259
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
05125
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
05125
NC
333600000X
Pharmacy
05125
NC
3336C0003X
Community/Retail Pharmacy
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
05125
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0387B
BLUE CROSS BLUE SHIELD
NC
05
—
0928275
—
NC
01
—
3426752
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
08/31/2012
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