Provider Demographics
NPI:1114106861
Name:STANLY REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:STANLY REGIONAL MEDICAL CENTER
Other - Org Name:ALBEMARLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:HARKEY
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:704-983-8222
Mailing Address - Street 1:105 YADKIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-3449
Mailing Address - Country:US
Mailing Address - Phone:704-983-8222
Mailing Address - Fax:704-983-8223
Practice Address - Street 1:105 YADKIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-3449
Practice Address - Country:US
Practice Address - Phone:704-983-8222
Practice Address - Fax:704-983-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07846332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703509Medicaid
NC7703509Medicaid
NC3626850001Medicare NSC