Provider Demographics
NPI:1083702187
Name:BELL'S DRUG STORE, INC.
Entity Type:Organization
Organization Name:BELL'S DRUG STORE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUFFUS
Authorized Official - Middle Name:LYNWOOD
Authorized Official - Last Name:DAUGHTRY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:252-728-3810
Mailing Address - Street 1:331 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-2124
Mailing Address - Country:US
Mailing Address - Phone:252-728-3810
Mailing Address - Fax:252-728-4857
Practice Address - Street 1:331 FRONT ST
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-2124
Practice Address - Country:US
Practice Address - Phone:252-728-3810
Practice Address - Fax:252-728-4857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC02543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3403742OtherNCPDP (NABP)
NC0165001Medicaid
NC0165001Medicaid