Provider Demographics
NPI:1376196063
Name:WINDSOR CHEMISTS ,INC
Entity type:Organization
Organization Name:WINDSOR CHEMISTS ,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAGHUNATH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOPPALAPUDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-794-3431
Mailing Address - Street 1:305 W GRANVILLE ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-1815
Mailing Address - Country:US
Mailing Address - Phone:252-794-3431
Mailing Address - Fax:252-794-2896
Practice Address - Street 1:305 W GRANVILLE ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-1815
Practice Address - Country:US
Practice Address - Phone:252-794-3431
Practice Address - Fax:252-794-2896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7767820001OtherMEDICARE (855S)
NC14175OtherBOARD OF PHARMACY
NCQ651120001OtherMEDICARE (855B)
NC3471860OtherNCPDP
NC1376196063Medicaid