Provider Demographics
NPI:1316561806
Name:VILLAGE PHARMACY OF HAMPSTEAD INC
Entity Type:Organization
Organization Name:VILLAGE PHARMACY OF HAMPSTEAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:MCBRAYER
Authorized Official - Last Name:CAVENESS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-520-2248
Mailing Address - Street 1:408 E CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-2140
Mailing Address - Country:US
Mailing Address - Phone:910-520-2248
Mailing Address - Fax:910-821-0330
Practice Address - Street 1:14057 HWY 17
Practice Address - Street 2:SUITE 100
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-2844
Practice Address - Country:US
Practice Address - Phone:910-319-6050
Practice Address - Fax:910-319-6045
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VILLAGE PHARMACY OF HAMPSTEAD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy