Provider Demographics
NPI:1437170628
Name:MITCHELL'S DISCOUNT DRUGS, INC
Entity Type:Organization
Organization Name:MITCHELL'S DISCOUNT DRUGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF CORPORATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-623-7747
Mailing Address - Street 1:544 MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-2524
Mailing Address - Country:US
Mailing Address - Phone:336-623-3132
Mailing Address - Fax:336-623-9127
Practice Address - Street 1:544 MORGAN RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-2524
Practice Address - Country:US
Practice Address - Phone:336-623-3132
Practice Address - Fax:336-623-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC04073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0795393Medicaid
NC7700845Medicaid
NC3419757OtherNABP
VA85133092Medicaid
VA85133092Medicaid