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Organization

BREVARD DRUG COMPANY LLC

Active
Other names
BREVARD DRUG COMPANY
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY JACKSON (PRESIDENT)
(828) 883-9757
Entity
Organization

Contact information

Practice address
518 S BROAD ST, BREVARD, NC 28712-4438
(828) 883-9757
(828) 883-2156
Mailing address
518 S BROAD ST, BREVARD, NC 28712-4438
(828) 883-9757
(828) 883-2156

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10409
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0885294
NC
01
3411484
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
06/12/2008
Last updated
08/01/2011
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