Provider Demographics
NPI:1184736191
Name:STAN RICH INC
Entity type:Organization
Organization Name:STAN RICH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-983-6177
Mailing Address - Street 1:944 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-3350
Mailing Address - Country:US
Mailing Address - Phone:704-983-6176
Mailing Address - Fax:704-984-6513
Practice Address - Street 1:944 N 1ST ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-3350
Practice Address - Country:US
Practice Address - Phone:704-983-6176
Practice Address - Fax:704-984-6513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC081833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3420801OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NC0845396Medicaid
3420801OtherNCPDP PROVIDER IDENTIFICATION NUMBER