Provider Demographics
NPI:1639214232
Name:WARSAW DRUG CO INC
Entity Type:Organization
Organization Name:WARSAW DRUG CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERLY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:910-293-4521
Mailing Address - Street 1:204 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-1833
Mailing Address - Country:US
Mailing Address - Phone:910-293-4521
Mailing Address - Fax:910-293-4521
Practice Address - Street 1:204 N FRONT ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NC
Practice Address - Zip Code:28398-1833
Practice Address - Country:US
Practice Address - Phone:910-293-4521
Practice Address - Fax:910-293-4521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC024163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0315051Medicaid
NC0520060001Medicare ID - Type Unspecified