Provider Demographics
NPI:1003890252
Name:AKERS PHARMACY INC
Entity Type:Organization
Organization Name:AKERS PHARMACY INC
Other - Org Name:AKERS PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:704-865-3411
Mailing Address - Street 1:1595 E GARRISON BLVD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-5138
Mailing Address - Country:US
Mailing Address - Phone:704-865-3411
Mailing Address - Fax:704-867-4262
Practice Address - Street 1:1595 E GARRISON BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5138
Practice Address - Country:US
Practice Address - Phone:704-865-3411
Practice Address - Fax:704-867-4262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC018313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0365007Medicaid
2067787OtherPK
NC0365007Medicaid