Provider Demographics
NPI:1831122530
Name:HOSPITAL PHARMACY INC.
Entity Type:Organization
Organization Name:HOSPITAL PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:336-786-4171
Mailing Address - Street 1:814 WORTH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-4561
Mailing Address - Country:US
Mailing Address - Phone:336-786-4171
Mailing Address - Fax:336-786-8856
Practice Address - Street 1:814 WORTH ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-4561
Practice Address - Country:US
Practice Address - Phone:336-786-4171
Practice Address - Fax:336-786-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC045913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0865394Medicaid
NC7700074Medicaid
NC0235550001Medicare ID - Type Unspecified