Provider Demographics
NPI:1710620935
Name:PHARMING COMPANY
Entity Type:Organization
Organization Name:PHARMING COMPANY
Other - Org Name:MATTHEWS DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-592-3121
Mailing Address - Street 1:6205 HOBBTON HWY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-5803
Mailing Address - Country:US
Mailing Address - Phone:910-305-9338
Mailing Address - Fax:910-592-3144
Practice Address - Street 1:408 NORTHEAST BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2434
Practice Address - Country:US
Practice Address - Phone:910-592-3121
Practice Address - Fax:910-592-3144
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMING COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-15
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7700182Medicaid
NC3564Medicaid
NC0476POtherBLUE CROSS BLUE SHIELD