Provider Demographics
NPI:1831480102
Name:GROWING CHILD OFFICE MEDS, INC.
Entity Type:Organization
Organization Name:GROWING CHILD OFFICE MEDS, INC.
Other - Org Name:GROWING CHILD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-215-0240
Mailing Address - Street 1:PO BOX 90216
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27675-0216
Mailing Address - Country:US
Mailing Address - Phone:919-215-0240
Mailing Address - Fax:
Practice Address - Street 1:500 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2158
Practice Address - Country:US
Practice Address - Phone:919-585-9001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GROWING CHILD OFFICE MEDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11013333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy