Provider Demographics
NPI:1578163135
Name:BL APOTHECARY
Entity Type:Organization
Organization Name:BL APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY OWNER/ STAFF PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRONSON
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-758-0115
Mailing Address - Street 1:2739 W 5TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-7819
Mailing Address - Country:US
Mailing Address - Phone:910-258-6056
Mailing Address - Fax:
Practice Address - Street 1:2739 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-7819
Practice Address - Country:US
Practice Address - Phone:910-258-6056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-31
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy