Provider Demographics
NPI:1437154481
Name:WENDELL DRUG CO. INC.
Entity Type:Organization
Organization Name:WENDELL DRUG CO. INC.
Other - Org Name:CORNER DRUG STORES OF WENDELL/WENDELL DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARM
Authorized Official - Phone:919-269-7481
Mailing Address - Street 1:303 N ARENDELL AVE
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-2605
Mailing Address - Country:US
Mailing Address - Phone:919-269-7481
Mailing Address - Fax:919-269-9998
Practice Address - Street 1:3430 WENDELL BLVD
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-6925
Practice Address - Country:US
Practice Address - Phone:919-365-8800
Practice Address - Fax:919-366-3659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC080443336C0003X
NC80443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1437154481Medicaid
2068995OtherPK
2068995OtherPK
NC5487530001Medicare NSC