Provider Demographics
NPI:1376589267
Name:MED CARE PHARMACY INC
Entity Type:Organization
Organization Name:MED CARE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-850-9496
Mailing Address - Street 1:5805 DEPARTURE DR
Mailing Address - Street 2:STE E
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-1859
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5805 DEPARTURE DR
Practice Address - Street 2:STE E
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-1859
Practice Address - Country:US
Practice Address - Phone:918-844-9248
Practice Address - Fax:919-850-9190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8401333600000X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3435028OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NC0929926Medicaid