Provider Demographics
NPI:1669687810
Name:UNITY
Entity Type:Organization
Organization Name:UNITY
Other - Org Name:UNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-521-7481
Mailing Address - Street 1:PO BOX 450
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-0450
Mailing Address - Country:US
Mailing Address - Phone:910-521-7481
Mailing Address - Fax:910-521-7482
Practice Address - Street 1:68 THREE HUNTS DR
Practice Address - Street 2:UNIT E
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-7318
Practice Address - Country:US
Practice Address - Phone:910-521-7481
Practice Address - Fax:910-521-7482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336L0003X
NC101443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3411751OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NC0785791Medicaid
3411751OtherNCPDP PROVIDER IDENTIFICATION NUMBER