Organization
GATEWAY PHARMACY LLC
Active
Other names
GATEWAY PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROY LEWTER (OWNER)
(336) 992-2111
Entity
Organization
Contact information
Practice address
510 PINEVIEW DR, KERNERSVILLE, NC 27284-3663
(336) 992-2111
(336) 992-2113
Mailing address
510 PINEVIEW DR, KERNERSVILLE, NC 27284-3663
(336) 992-2111
(336) 992-2113
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
08506
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0347199
—
NC
01
—
2070330
PK
—
Enumeration date
03/29/2006
Last updated
03/06/2017
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