Organization
BLACK RIVER HEALTH SERVICES INC
Active
Other names
Maple Hill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
YORONDA ARTECIAH FORDE PHARM.D. (PHARMACY MANAGER)
(910) 259-8880
Entity
Organization
Contact information
Practice address
4811 NC HWY 50, MAPLE HILL, NC 28454-8153
(910) 259-8880
(910) 259-4144
Mailing address
4811 HWY 50, MAPLE HILL, NC 28454
(910) 259-8880
(910) 259-4144
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
08408
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0715269
—
NC
01
—
2070019
PK
—
Enumeration date
09/30/2005
Last updated
05/23/2022
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