Provider Demographics
NPI:1083083950
Name:REALO DISCOUNT DRUG STORES OF EASTERN NORTH CAROLINA INC
Entity Type:Organization
Organization Name:REALO DISCOUNT DRUG STORES OF EASTERN NORTH CAROLINA INC
Other - Org Name:REALO DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:RHP
Authorized Official - Phone:252-639-9006
Mailing Address - Street 1:1301 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2213
Mailing Address - Country:US
Mailing Address - Phone:252-639-9006
Mailing Address - Fax:252-639-9005
Practice Address - Street 1:502 W THURMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-7020
Practice Address - Country:US
Practice Address - Phone:252-631-5444
Practice Address - Fax:252-631-5110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ486960005OtherMEDICARE FLU
NC12704OtherNORTH CAROLINA BOARD OF PHARMACY
NC12704OtherNORTH CAROLINA BOARD OF PHARMACY