Provider Demographics
NPI:1235332578
Name:RICHMOND COUNTY HEALTH DEPARTMENT PHARMACY
Entity Type:Organization
Organization Name:RICHMOND COUNTY HEALTH DEPARTMENT PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-410-1108
Mailing Address - Street 1:127 CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-3567
Mailing Address - Country:US
Mailing Address - Phone:910-410-1108
Mailing Address - Fax:910-997-8246
Practice Address - Street 1:127 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3567
Practice Address - Country:US
Practice Address - Phone:910-410-1108
Practice Address - Fax:910-997-8246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC04133251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3401534OtherNCPDP