Provider Demographics
NPI:1750486494
Name:SNEADS FERRY FAMILY PHARMACY INC
Entity Type:Organization
Organization Name:SNEADS FERRY FAMILY PHARMACY INC
Other - Org Name:SNEADS FERRY FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHCY MGR
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-327-2454
Mailing Address - Street 1:1016 OLD FOLKSTONE RD STE 214
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-9414
Mailing Address - Country:US
Mailing Address - Phone:910-327-2454
Mailing Address - Fax:910-327-2543
Practice Address - Street 1:1016 OLD FOLKSTONE RD STE 214
Practice Address - Street 2:
Practice Address - City:SNEADS FERRY
Practice Address - State:NC
Practice Address - Zip Code:28460-9414
Practice Address - Country:US
Practice Address - Phone:910-327-2454
Practice Address - Fax:910-327-2543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC092363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3405253OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NC0675652Medicaid