Provider Demographics
NPI:1568516904
Name:SUTTON'S DRUG STORE INC.
Entity Type:Organization
Organization Name:SUTTON'S DRUG STORE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:VERNON
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:919-942-5161
Mailing Address - Street 1:159 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-3620
Mailing Address - Country:US
Mailing Address - Phone:919-942-5161
Mailing Address - Fax:919-967-0185
Practice Address - Street 1:159 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-3620
Practice Address - Country:US
Practice Address - Phone:919-942-5161
Practice Address - Fax:919-967-0185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy