Organization
ELM CITY PHARMACY INC
Active
Other names
ELM CITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN RUSSELL COWAN RPH (PRESIDENT)
(252) 236-4664
Entity
Organization
Contact information
Practice address
118 EAST MAIN STREET, ELM CITY, NC 27822
(252) 236-4664
(252) 236-3078
Mailing address
PO BOX 637, ELM CITY, NC 27822-0637
(252) 236-4664
(252) 236-3078
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
04043
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
04043
NC
3336C0003X
Community/Retail Pharmacy
04043
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0387E
BLUE CROSS BLUE SHIELD
NC
05
—
0985259
—
NC
05
—
7700546
—
NC
Enumeration date
10/24/2006
Last updated
09/11/2025
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