Provider Demographics
NPI:1770657207
Name:ROWLAND FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:ROWLAND FAMILY PHARMACY LLC
Other - Org Name:ROWLAND FAMILY PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARM AND MGR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:910-422-3774
Mailing Address - Street 1:101 S BOND ST
Mailing Address - Street 2:
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-9639
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 S BOND ST
Practice Address - Street 2:
Practice Address - City:ROWLAND
Practice Address - State:NC
Practice Address - Zip Code:28383-9639
Practice Address - Country:US
Practice Address - Phone:910-422-3774
Practice Address - Fax:910-422-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC083813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0785708Medicaid
3441300OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3948830002Medicare NSC