Provider Demographics
NPI:1518587443
Name:SEVEN LAKES PRESCRIPTION SHOPPE INC
Entity Type:Organization
Organization Name:SEVEN LAKES PRESCRIPTION SHOPPE INC
Other - Org Name:RX CLINICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-673-7467
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-0526
Mailing Address - Country:US
Mailing Address - Phone:910-673-7467
Mailing Address - Fax:
Practice Address - Street 1:120 MAC DOUGALL DR
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-9342
Practice Address - Country:US
Practice Address - Phone:910-673-7467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEVEN LAKES PRESCRIPTION SHOPPE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-21
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty