Organization
EGB ENTERPRISES INC
Active
Other names
VILLAGE PRESCRIPTION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE BROWN (PRES PHCST)
(910) 646-3400
Entity
Organization
Contact information
Practice address
108 OLD E HWY 74/76, LAKE WACCAMAW, NC 28450-0148
(910) 646-3400
(910) 646-4056
Mailing address
PO BOX 148, PO, LAKE WACCAMAW, NC 28450-0148
(910) 646-3400
(910) 646-3400
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
03991
NC
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2068421
PK
—
05
—
245530
—
NC
Enumeration date
10/23/2006
Last updated
12/08/2016
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