Provider Demographics
NPI:1356977672
Name:CAPE FEAR DISCOUNT DRUG - HOPE MILLS, LLC
Entity type:Organization
Organization Name:CAPE FEAR DISCOUNT DRUG - HOPE MILLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-779-4242
Mailing Address - Street 1:3018 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-1722
Mailing Address - Country:US
Mailing Address - Phone:910-779-4242
Mailing Address - Fax:910-779-4244
Practice Address - Street 1:3018 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-1722
Practice Address - Country:US
Practice Address - Phone:910-779-4242
Practice Address - Fax:910-779-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy