Provider Demographics
NPI:1609827906
Name:BRYAN DRUGS INC
Entity Type:Organization
Organization Name:BRYAN DRUGS INC
Other - Org Name:BRYAN DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:252-823-3178
Mailing Address - Street 1:112 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-2012
Mailing Address - Country:US
Mailing Address - Phone:252-823-3178
Mailing Address - Fax:252-823-8055
Practice Address - Street 1:112 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-2012
Practice Address - Country:US
Practice Address - Phone:252-823-3178
Practice Address - Fax:252-823-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC047333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2069548OtherPK
NC7700869Medicaid
NC0335281Medicaid
NC0335281Medicaid