Provider Demographics
NPI:1639642200
Name:BURY DRUG, INC.
Entity Type:Organization
Organization Name:BURY DRUG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:BURY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:919-933-7629
Mailing Address - Street 1:104 NC 54 STE J
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-1597
Mailing Address - Country:US
Mailing Address - Phone:919-933-7629
Mailing Address - Fax:919-933-7631
Practice Address - Street 1:104 NC 54 STE J
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1597
Practice Address - Country:US
Practice Address - Phone:919-933-7629
Practice Address - Fax:919-933-7631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy