Provider Demographics
NPI:1922433374
Name:DUGGINS HOLDINGS LLC
Entity Type:Organization
Organization Name:DUGGINS HOLDINGS LLC
Other - Org Name:PREVO DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-625-4311
Mailing Address - Street 1:363 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5611
Mailing Address - Country:US
Mailing Address - Phone:336-625-4311
Mailing Address - Fax:336-625-1966
Practice Address - Street 1:363 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5611
Practice Address - Country:US
Practice Address - Phone:336-625-4311
Practice Address - Fax:336-625-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
NC117513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142872OtherPK
NC7064550001Medicare NSC