Provider Demographics
NPI:1598171910
Name:EXPRESS DISCOUNT PHARMACY LLC
Entity Type:Organization
Organization Name:EXPRESS DISCOUNT PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHIJIOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-491-2431
Mailing Address - Street 1:1905 SKIBO RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-0261
Mailing Address - Country:US
Mailing Address - Phone:910-491-2431
Mailing Address - Fax:910-491-2671
Practice Address - Street 1:1905 SKIBO RD STE 104
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0261
Practice Address - Country:US
Practice Address - Phone:910-491-2431
Practice Address - Fax:910-491-2671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC120383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy