Provider Demographics
NPI:1235419318
Name:MORGANTON DRUG, INC.
Entity Type:Organization
Organization Name:MORGANTON DRUG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/RX MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:PARKS
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:828-433-6353
Mailing Address - Street 1:500 S STERLING ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3573
Mailing Address - Country:US
Mailing Address - Phone:828-433-6353
Mailing Address - Fax:828-433-4457
Practice Address - Street 1:500 S STERLING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3573
Practice Address - Country:US
Practice Address - Phone:828-433-6353
Practice Address - Fax:828-433-4457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11079332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0125593Medicaid
NC3419240OtherNCPDP
NC6656440001Medicare NSC