Provider Demographics
NPI:1124008933
Name:HUDSON DISCOUNT DRUG
Entity type:Organization
Organization Name:HUDSON DISCOUNT DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:CRTT RCP
Authorized Official - Phone:828-726-0901
Mailing Address - Street 1:510 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638-2401
Mailing Address - Country:US
Mailing Address - Phone:828-726-0901
Mailing Address - Fax:828-726-0436
Practice Address - Street 1:510 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NC
Practice Address - Zip Code:28638-2401
Practice Address - Country:US
Practice Address - Phone:828-726-0901
Practice Address - Fax:828-726-0436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0779500001Medicare ID - Type UnspecifiedPROVIDER #