Provider Demographics
NPI:1417618604
Name:MCDOWELLS PHARMACY INC
Entity Type:Organization
Organization Name:MCDOWELLS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:252-826-4137
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:SCOTLAND NECK
Mailing Address - State:NC
Mailing Address - Zip Code:27874-0160
Mailing Address - Country:US
Mailing Address - Phone:252-826-4137
Mailing Address - Fax:252-826-4663
Practice Address - Street 1:1004 MAIN ST
Practice Address - Street 2:
Practice Address - City:SCOTLAND NECK
Practice Address - State:NC
Practice Address - Zip Code:27874-1232
Practice Address - Country:US
Practice Address - Phone:252-826-4137
Practice Address - Fax:252-826-4663
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCDOWELLS PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0425058Medicaid