Organization
ELVINGTON DRUG LLC
Active
Other names
Elvington Drug
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LUNDY (MEMBER-MANAGER)
(910) 649-7721
Entity
Organization
Contact information
Practice address
1126 MAIN STREET, FAIR BLUFF, NC 28439
(910) 649-7721
(910) 649-6515
Mailing address
PO BOX 98, FAIR BLUFF, NC 28439-0098
(910) 649-7721
(910) 649-6515
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
11045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3405974
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/02/2006
Last updated
06/29/2011
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