Organization
INNES STREET DRUG COMPANY
Active
Other names
INNES STREET DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES FULLER (PRESIDENT OWNER)
(704) 636-1712
Entity
Organization
Contact information
Practice address
1706 W INNES ST, SALISBURY, NC 28144-2552
(704) 636-1712
(704) 637-0324
Mailing address
PO BOX 4065, SALISBURY, NC 28145-4065
(704) 633-4521
(704) 633-1893
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05609
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805473
—
NC
01
—
2067260
PK
—
Enumeration date
06/13/2006
Last updated
11/17/2014
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