Organization
TWO RIVERS PHARMACY INC
Active
Other names
Two Rivers Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DEESE (PM/OWNER)
(910) 734-4896
Entity
Organization
Contact information
Practice address
101 BROADFOOT AVE, FAYETTEVILLE, NC 28305-5001
(910) 748-0243
(910) 748-0245
Mailing address
101 BROADFOOT AVE, FAYETTEVILLE, NC 28305-5001
(910) 483-5450
(910) 483-6228
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
12778
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155961
PK
—
Enumeration date
12/14/2015
Last updated
07/25/2016
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