Provider Information for 1215047907
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KERR DRUG INC
Other Names:Doing Business As:KERR DRUGOrganization Subpart: NO
NPI: 1215047907
Last Updated: 2012-01-04
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||
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NPI | 1215047907 | ||||||||||||
Enumeration Date | 2006-08-30 | ||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||
Status | Active | ||||||||||||
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 | 302 E MAIN ST CHERRYVILLE, NC 28021-3411 United States Phone: 704-445-8763 | Fax:704-445-2133 | ||||||||||||
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