Provider Demographics
NPI:1255336285
Name:ZEBULON DRUG COMPANY INC
Entity type:Organization
Organization Name:ZEBULON DRUG COMPANY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTON
Authorized Official - Middle Name:PRENTISS
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:III
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:252-943-1913
Mailing Address - Street 1:303 N ARENDELL AVE
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-2605
Mailing Address - Country:US
Mailing Address - Phone:919-269-7481
Mailing Address - Fax:919-269-9998
Practice Address - Street 1:303 N ARENDELL AVE
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-2605
Practice Address - Country:US
Practice Address - Phone:919-269-7481
Practice Address - Fax:919-269-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC04655332B00000X, 3336C0003X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3412688OtherNCPDP (FORMER NABP)
NC15191OtherNC BOARD OF PHARMACY
NC04655OtherNC BOARD OF PHARMACY
NC1023702990Medicaid
NC1255336285Medicaid