Provider Demographics
NPI:1447573969
Name:REALO DISCOUNT DRUGS OF ONSLOW INC
Entity Type:Organization
Organization Name:REALO DISCOUNT DRUGS OF ONSLOW INC
Other - Org Name:REALO DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:252-639-9006
Mailing Address - Street 1:1301 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2213
Mailing Address - Country:US
Mailing Address - Phone:252-639-9006
Mailing Address - Fax:252-639-9005
Practice Address - Street 1:423 YOPP RD STE 200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-3594
Practice Address - Country:US
Practice Address - Phone:910-347-9684
Practice Address - Fax:910-455-0622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
NC104893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2124153OtherPK
NC10489OtherNCBOP
2124153OtherPK
NC6431660001Medicare NSC