Provider Demographics
NPI:1760956080
Name:NORTH MAIN HEALTH INVESTORS INC
Entity Type:Organization
Organization Name:NORTH MAIN HEALTH INVESTORS INC
Other - Org Name:NORTH MAIN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:336-756-7855
Mailing Address - Street 1:901 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-3746
Mailing Address - Country:US
Mailing Address - Phone:336-756-7855
Mailing Address - Fax:336-756-7856
Practice Address - Street 1:901 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-3746
Practice Address - Country:US
Practice Address - Phone:336-756-7855
Practice Address - Fax:336-756-7856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13990OtherNC BOARD OF PHARMACY