Organization
DAMERON DRUG STORE INC
Active
Other names
DAMERON DISCOUNT DRUGS HEALTH MART
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DAMERON (VICE PRESIDENT/COMPLIANCE OFFICER)
(910) 653-3089
Entity
Organization
Contact information
Practice address
100 S MAIN ST, TABOR CITY, NC 28463
(910) 653-3089
(910) 653-5839
Mailing address
100 S MAIN ST, TABOR CITY, NC 28463-1910
(910) 653-3089
(910) 653-5839
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00917
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0245100
—
NC
01
—
2067496
PK
—
05
—
7N0917
—
SC
Enumeration date
03/01/2006
Last updated
08/07/2018
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