Provider Demographics
NPI:1518978170
Name:BEAR DRUGS INC
Entity Type:Organization
Organization Name:BEAR DRUGS INC
Other - Org Name:BEAR DRUGS OF KITTY HAWK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-261-7999
Mailing Address - Street 1:PO BOX 988
Mailing Address - Street 2:
Mailing Address - City:KITTY HAWK
Mailing Address - State:NC
Mailing Address - Zip Code:27949-0988
Mailing Address - Country:US
Mailing Address - Phone:252-261-7999
Mailing Address - Fax:252-261-3333
Practice Address - Street 1:5200 N CROATAN HWY
Practice Address - Street 2:STE 10 AND 11
Practice Address - City:KITTY HAWK
Practice Address - State:NC
Practice Address - Zip Code:27949-3990
Practice Address - Country:US
Practice Address - Phone:252-261-7999
Practice Address - Fax:252-261-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC046643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0285189Medicaid
2069183OtherPK
4987000001Medicare NSC