Provider Demographics
NPI:1851538144
Name:FUTRELL PHARMACY SERVICE INC
Entity Type:Organization
Organization Name:FUTRELL PHARMACY SERVICE INC
Other - Org Name:FUTRELL PHARMACY OF LITTLETON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:FUTRELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:252-534-6001
Mailing Address - Street 1:123 EAST SOUTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NC
Mailing Address - Zip Code:27850-0532
Mailing Address - Country:US
Mailing Address - Phone:252-586-3414
Mailing Address - Fax:252-586-5377
Practice Address - Street 1:123 EAST SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NC
Practice Address - Zip Code:27850-0532
Practice Address - Country:US
Practice Address - Phone:252-586-3414
Practice Address - Fax:252-586-5377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7705255Medicaid
NC10217OtherNC BOARD OF PHARMACY
NC10217OtherNC BOARD OF PHARMACY