Organization
DICKERSONS PHARMACY INC
Active
Other names
DICKERSONS PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE DICKERSON RPH (PRES)
(910) 862-3465
Entity
Organization
Contact information
Practice address
503 DOCTORS DR, ELIZABETHTOWN, NC 28337
(910) 862-3465
(910) 862-4917
Mailing address
503 DOCTORS DR, PO BOX 426, ELIZABETHTOWN, NC 28337
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
04491
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095182
—
NC
01
—
2065838
PK
—
05
—
7701212
—
NC
Enumeration date
12/27/2006
Last updated
01/18/2017
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