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Provider Information for 1669582359


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KERR DRUG INC

Other Names:  
Doing Business As: 
KERR DRUG

Organization Subpart: NO

NPI: 1669582359
Last Updated: 2012-01-18
Certification Date:

Details

NameValue
NPI1669582359
Enumeration Date2006-08-30
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: MARK GREGORY RPH
Title: VP OF PHARMACY
Phone: 9195443896
Mailing Address 3220 SPRING FOREST RD
RALEIGH, NC 27616-2822
United States

Phone: 919-544-3896 | Fax:919-544-7719
 
Primary Practice Address 1587 SKEET CLUB RD
HIGH POINT, NC 27265-9530
United States

Phone: 336-454-4327 | Fax:336-841-0406
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNC0417666
Other (non-Medicare)3433454NCPDP Provider Identification Number
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 333600000X - Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyNC6882