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Organization

WATERS DRUG COMPANY LLC

Active
Other names
WATERS DRUG COMPANY
Organization subpart
No

Provider details

NPI number
Authorized official
WESLEY WATERS RPH (OWNER)
(910) 691-1022
Entity
Organization

Contact information

Practice address
201 LIVERMORE DR, PEMBROKE, NC 28372-7322
(910) 522-5152
(910) 739-7207
Mailing address
201 LIVERMORE DR, PEMBROKE, NC 28372-7322
(910) 522-5152
(910) 522-5098

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10062
NC
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2067270
PK
Enumeration date
03/10/2008
Last updated
02/11/2015
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