Provider Demographics
NPI:1821117318
Name:BEAR DRUGS OF NAGS HEAD INC.
Entity Type:Organization
Organization Name:BEAR DRUGS OF NAGS HEAD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARCHBELL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:252-441-1252
Mailing Address - Street 1:PO BOX 988
Mailing Address - Street 2:
Mailing Address - City:KITTY HAWK
Mailing Address - State:NC
Mailing Address - Zip Code:27949-0988
Mailing Address - Country:US
Mailing Address - Phone:252-441-1252
Mailing Address - Fax:
Practice Address - Street 1:4711 S. CROATAN HWY
Practice Address - Street 2:UNIT #4
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959
Practice Address - Country:US
Practice Address - Phone:252-441-1252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC095073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6336450001Medicare NSC