Provider Demographics
NPI:1346632825
Name:FOSTER DRUG CO INC
Entity Type:Organization
Organization Name:FOSTER DRUG CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY/TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:CARTNER
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-751-2141
Mailing Address - Street 1:495 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27028-2074
Mailing Address - Country:US
Mailing Address - Phone:336-751-2141
Mailing Address - Fax:336-751-7974
Practice Address - Street 1:495 VALLEY RD
Practice Address - Street 2:
Practice Address - City:MOCKSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27028-2074
Practice Address - Country:US
Practice Address - Phone:336-751-2141
Practice Address - Fax:336-751-7974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0305086Medicaid
NC0132880001Medicare NSC