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Organization

WOODARD DRUG STORE INC

Active
Other names
WOODARD DRUG STORE INC
Organization subpart
No

Provider details

NPI number
Authorized official
WANDA CROCKER (PRESIDENT)
(919) 936-3151
Entity
Organization

Contact information

Practice address
102 E EDWARDS ST, PRINCETON, NC 27569-7279
(919) 936-3151
(919) 936-3015
Mailing address
PO BOX 5, PRINCETON, NC 27569-0005
(919) 936-3151
(919) 936-3015

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
07097
NC
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0515098
NC
01
2066643
PK
Enumeration date
09/21/2006
Last updated
01/04/2019
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