Provider Demographics
NPI:1346396041
Name:STANTONSBURG DRUG COMPANY, INC
Entity Type:Organization
Organization Name:STANTONSBURG DRUG COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROWLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-238-3539
Mailing Address - Street 1:105 S MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:STANTONSBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27883-0040
Mailing Address - Country:US
Mailing Address - Phone:252-238-3539
Mailing Address - Fax:252-238-2749
Practice Address - Street 1:105 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STANTONSBURG
Practice Address - State:NC
Practice Address - Zip Code:27883-0040
Practice Address - Country:US
Practice Address - Phone:252-238-3539
Practice Address - Fax:252-238-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0375NOtherBCBS
NC7701139Medicaid
NC0459000001Medicare ID - Type Unspecified
NC7701139Medicaid