Provider Demographics
NPI:1104396258
Name:BL APOTHECARY
Entity Type:Organization
Organization Name:BL APOTHECARY
Other - Org Name:BL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:BRONSON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-359-8009
Mailing Address - Street 1:229 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RED SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28377-1621
Mailing Address - Country:US
Mailing Address - Phone:910-359-8009
Mailing Address - Fax:910-227-2397
Practice Address - Street 1:229 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RED SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28377-1621
Practice Address - Country:US
Practice Address - Phone:910-359-8009
Practice Address - Fax:910-227-2397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy