Provider Demographics
NPI:1912141623
Name:MARSHALL FAMILY PHARMACY, INC.
Entity Type:Organization
Organization Name:MARSHALL FAMILY PHARMACY, INC.
Other - Org Name:MARSHALL FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH,MBA
Authorized Official - Phone:828-689-2667
Mailing Address - Street 1:144 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MARS HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28754-9700
Mailing Address - Country:US
Mailing Address - Phone:828-649-0682
Mailing Address - Fax:828-689-2681
Practice Address - Street 1:5115 HWY 25-70
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-6448
Practice Address - Country:US
Practice Address - Phone:828-649-0682
Practice Address - Fax:828-649-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-24
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6255940002Medicare NSC