Organization
FARMVILLE DISCOUNT DRUG, INC.
Active
Other names
Best Value Drug
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L CROCKER R.PH (PRESIDENT)
(252) 753-2092
Entity
Organization
Contact information
Practice address
3708 N MAIN ST, FARMVILLE, NC 27828-1465
(252) 753-2092
(252) 753-2499
Mailing address
PO BOX 690, FARMVILLE, NC 27828-0690
(252) 753-2092
(252) 753-2499
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
03259
NC
3336C0003X
Community/Retail Pharmacy
Primary
03259
NC
3336C0004X
Compounding Pharmacy
03259
NC
3336H0001X
Home Infusion Therapy Pharmacy
03259
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0745224
—
NC
05
—
6800352
—
NC
05
—
7700071
—
NC
Enumeration date
08/10/2005
Last updated
10/27/2009
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