Organization
HOMETOWN DISCOUNT PHARMACY OF GREENVILLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JACKSON (PRESIDENT AND OWNER)
(252) 752-0003
Entity
Organization
Contact information
Practice address
1631 GREENVILLE BLVD SE, GREENVILLE, NC 27858-4809
(252) 752-0003
(252) 752-3145
Mailing address
1631 GREENVILLE BLVD SE, GREENVILLE, NC 27858-4809
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
08421
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0745894
—
NC
01
—
3439127
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/03/2006
Last updated
11/16/2010
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