Organization
SERVICE DRUG STORE OF PINETOPS INC
Active
Other names
SERVICE DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY HOGG (OWNER)
(252) 527-5532
Entity
Organization
Contact information
Practice address
102 WEST HAMLET STREET, PINETOPS, NC 27864
(252) 827-5532
(252) 827-2741
Mailing address
PO BOX O, PINETOPS, NC 27864-0350
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
04750
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0335042
—
NC
01
—
3409720
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/14/2006
Last updated
01/05/2011
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