Provider Demographics
NPI:1851624068
Name:PEMBROKE DRUG CENTER
Entity Type:Organization
Organization Name:PEMBROKE DRUG CENTER
Other - Org Name:HEALTH KEEPERZ HME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-522-0001
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-1030
Mailing Address - Country:US
Mailing Address - Phone:910-522-0001
Mailing Address - Fax:910-521-1049
Practice Address - Street 1:241 SINGLETON RIDGE RD UNIT B
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8371
Practice Address - Country:US
Practice Address - Phone:843-347-5661
Practice Address - Fax:843-347-5667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies