Organization
WALLACE DRUG CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGBERT MCLEMORE RPH (OWNER/PIC)
(910) 285-3101
Entity
Organization
Contact information
Practice address
100 W MAIN ST, WALLACE, NC 28466-2902
(910) 285-3101
(910) 285-5834
Mailing address
100 W MAIN ST, WALLACE, NC 28466-2902
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
333600000X
Pharmacy
05081
NC
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315234
—
NC
01
—
3426118
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/07/2006
Last updated
09/11/2025
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