Provider Information for 1609942366
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MAST DRUG CO INC
Other Names:Doing Business As:MAST PHARMACYOrganization Subpart: NO
NPI: 1609942366
Last Updated: 2022-08-26
Certification Date: 2022-08-16
Certification Date: 2022-08-16
Details
| Name | Value | ||||||||||||||||
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| NPI | 1609942366 | ||||||||||||||||
| Enumeration Date | 2006-11-27 | ||||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Authorized Official Information | Name: RICHARD I FLYE Jr. Title: PRESIDENT Phone: 2524383112 | ||||||||||||||||
| Mailing Address | 805 S GARNETT ST HENDERSON, NC 27536 United States Phone: 252-438-3112 | Fax:252-492-4096 | ||||||||||||||||
| Primary Practice Address | 307 WEST BLVD WILLIAMSTON, NC 27892-2145 United States Phone: 252-792-1015 | Fax:252-792-2174 | ||||||||||||||||
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