Organization
FARMVILLE DISCOUNT DRUG, INC
Active
Other names
BEST VALUE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LEE CROCKER RPH (PRESIDENT)
(252) 753-2093
Entity
Organization
Contact information
Practice address
3708 N MAIN ST, FARMVILLE, NC 27828-1499
(252) 753-2093
(252) 753-2499
Mailing address
PO BOX 690, FARMVILLE, NC 27828-0690
(252) 753-2093
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3259
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0745224
—
NC
01
—
2801165
MEDICARE MASS IMMUNIZATION ROSTER
NC
Enumeration date
11/19/2008
Last updated
10/23/2009
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