Provider Demographics
NPI:1922159888
Name:RX LABOR INC.
Entity Type:Organization
Organization Name:RX LABOR INC.
Other - Org Name:CLARKS HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:WESTER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:252-792-7841
Mailing Address - Street 1:112 E MAIN ST
Mailing Address - Street 2:#A
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2480
Mailing Address - Country:US
Mailing Address - Phone:252-792-7841
Mailing Address - Fax:252-789-8401
Practice Address - Street 1:112 E MAIN ST
Practice Address - Street 2:#A
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2480
Practice Address - Country:US
Practice Address - Phone:252-792-7841
Practice Address - Fax:252-789-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01464332B00000X, 332BP3500X, 332BX2000X
NC083103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703909Medicaid
NC4907090001Medicare ID - Type Unspecified
NC7703909Medicaid