Provider Demographics
NPI:1881849263
Name:1ST RX PHARMACY INC - GREENBRIAR
Entity Type:Organization
Organization Name:1ST RX PHARMACY INC - GREENBRIAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:NORTON
Authorized Official - Last Name:MARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-872-9215
Mailing Address - Street 1:837 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-3222
Mailing Address - Country:US
Mailing Address - Phone:704-872-0880
Mailing Address - Fax:704-871-0440
Practice Address - Street 1:308A MOCKSVILLE HWY
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-8267
Practice Address - Country:US
Practice Address - Phone:704-878-6225
Practice Address - Fax:704-878-6211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10196333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy