Provider Demographics
NPI:1508951161
Name:ROCKY MOUNT DRUGS INC
Entity type:Organization
Organization Name:ROCKY MOUNT DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KITCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-442-5200
Mailing Address - Street 1:1329 TARBORO ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-6070
Mailing Address - Country:US
Mailing Address - Phone:252-446-0014
Mailing Address - Fax:252-446-0212
Practice Address - Street 1:1329 TARBORO ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-6070
Practice Address - Country:US
Practice Address - Phone:252-446-0014
Practice Address - Fax:252-446-0212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3105332B00000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0335158Medicaid
NC0335158Medicaid