Organization
GRACA INC
Active
Other names
COMMUNITY CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DANA GOLDSTON RPH (PRESIDENT)
(940) 754-5857
Entity
Organization
Contact information
Practice address
143 ROSEDALE DR, ELIZABETH CITY, NC 27909-9810
(252) 331-2965
(252) 335-0329
Mailing address
PO BOX 1778, LITTLE RIVER, SC 29566-1778
(252) 331-2965
(252) 335-0329
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
09191
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3404732
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
7704429
—
NC
Enumeration date
10/26/2006
Last updated
08/05/2009
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