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 PHARMACIST)
(252) 236-4664
Entity
Organization
Contact information
Practice address
118 E MAIN ST, ELM CITY, NC 27822-0637
(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
4043
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
004043
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
4043
NC
333600000X
Pharmacy
04043
NC
3336C0003X
Community/Retail Pharmacy
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
004043
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0387E
BLUE CROSS
NC
01
—
3405924
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
7700546
—
NC
Enumeration date
09/21/2006
Last updated
03/27/2008
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