Provider Demographics
NPI:1417281536
Name:CAROLINA APOTHECARY INC
Entity Type:Organization
Organization Name:CAROLINA APOTHECARY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:336-394-1100
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27323-0029
Mailing Address - Country:US
Mailing Address - Phone:336-342-0071
Mailing Address - Fax:336-342-7660
Practice Address - Street 1:238 W KINGS HWY
Practice Address - Street 2:SUITE B
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5095
Practice Address - Country:US
Practice Address - Phone:336-623-3030
Practice Address - Fax:336-623-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00129332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9102124Medicaid
NC04197OtherBCBS OF NC
NC3408748Medicaid
NC4804OtherPARTNERS
NC8207703OtherUNITED HEALTH CARE
NC7700018Medicaid
VA9102124Medicaid