Provider Demographics
NPI:1558539056
Name:BEST VALUE MED CARE PHARMACY
Entity Type:Organization
Organization Name:BEST VALUE MED CARE PHARMACY
Other - Org Name:BEST VALUE MED CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CROCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-753-2323
Mailing Address - Street 1:PO BOX 44
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27828-0044
Mailing Address - Country:US
Mailing Address - Phone:252-753-2323
Mailing Address - Fax:252-753-7394
Practice Address - Street 1:3309 BONNIES ALLEY
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:NC
Practice Address - Zip Code:27828
Practice Address - Country:US
Practice Address - Phone:252-753-2323
Practice Address - Fax:252-753-7394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336C0004X, 3336M0002X, 3336S0011X
NC099973336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3410228OtherNCPDP PROVIDER IDENTIFICATION NUMBER