Provider Demographics
NPI:1932442514
Name:COMMUNITY PHARMACY OF ALBEMARLE, LLC
Entity Type:Organization
Organization Name:COMMUNITY PHARMACY OF ALBEMARLE, LLC
Other - Org Name:MEDICAL PHARMACY OF UWHARRIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:CASTELLOE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:704-982-9179
Mailing Address - Street 1:1420 US HIGHWAY 52 N
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-2622
Mailing Address - Country:US
Mailing Address - Phone:704-982-9179
Mailing Address - Fax:704-983-5557
Practice Address - Street 1:1420 US HIGHWAY 52 N
Practice Address - Street 2:SUITE C
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2622
Practice Address - Country:US
Practice Address - Phone:704-982-9179
Practice Address - Fax:704-983-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC115013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy