Provider Demographics
NPI:1902396732
Name:OPPORTUNITIES INDUSTRIALIZATION CENTER, INC
Entity Type:Organization
Organization Name:OPPORTUNITIES INDUSTRIALIZATION CENTER, INC
Other - Org Name:OIC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:252-212-3480
Mailing Address - Street 1:PO BOX 2723
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27802-2723
Mailing Address - Country:US
Mailing Address - Phone:252-212-3486
Mailing Address - Fax:252-212-3497
Practice Address - Street 1:300 N GRACE ST STE 150
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804
Practice Address - Country:US
Practice Address - Phone:252-316-8220
Practice Address - Fax:252-822-5065
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPPORTUNITIES INDUSTRIALIZATION CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-17
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy