Beulaville Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Beulaville, NC
NPI 1003069832 · NPPES record last updated Jan 17, 2017
Key facts
- NPI
- 1003069832
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 10177 (NC)
- Legal business name
- BEULAVILLE PHARMACY INC
- Practice address
- 103 Crossover Rd
Beulaville, NC 28518-8801 - Phone
- (910) 298-3093
- NPI assigned
- Oct 24, 2008
- Organization subpart
- No
Authorized official
- Name
- Christopher Dixon
- Title
- Owner Phcy Manager
- Phone
- (252) 626-4343
Practitioners 2
-
Laurie Alejo, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100724000085 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 6608908728 | Practice locations: Beulaville, NC |
National Provider Directory
Locations
114 Crossover Rd
Beulaville, NC 28518
Phone (910) 298-3093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 10177 | NC | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
103 Crossover Rd
Beulaville, NC 28518-8801
Mailing address
PO Box 429
Beulaville, NC 28518-0429
Phone (910) 298-3093
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2117564 | Other | PK |
Other names
- Beulaville Pharmacy Inc
Other providers in Beulaville, NC
- Ashley Ivey Anderson
- Autumn Village, Inc.
- Gary Batts
- Beulaville Chiropractic PLLC
- Beulaville Eye Care, Inc.
- Taylor Blizzard
- Demetria Boone
- Tommie F Bostic Jr.
- Morgan Brann
- Amanda Brinson
All providers in Beulaville, NC · Community/Retail Pharmacy in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.