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Organization

FALLS RIVER PHARMACY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROMAS T. WHITE III RPH (MEMBER-MANAGER)
(919) 835-0457
Entity
Organization

Contact information

Practice address
10930 RAVEN RIDGE RD, SUITE 109, RALEIGH, NC 27614-8725
(919) 844-2055
(919) 844-2054
Mailing address
10930 RAVEN RIDGE RD, SUITE 109, RALEIGH, NC 27614-8725
(919) 844-2055
(919) 844-2054

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
9162
NC
3336C0003X
Community/Retail Pharmacy
Primary
9162
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0920845
NC
01
3434987
NCPDP NUMBER
NC
05
7704396
NC
Enumeration date
05/28/2006
Last updated
07/26/2013
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