Eden Drug, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

EDEN DRUG, INC.

Practice address

103 W Stadium Dr
Eden, NC 27288-3329

Phone

(336) 627-4854

NPI assigned

Mar 18, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Crouch

Title

Pharmacist

Phone

(336) 627-4854

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Eden Drug Health Mart2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eden Drug, Inc.

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1740246677
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1053947366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W STADIUM DR",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272883329",
            "telephone_number": "336-627-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W STADIUM DR",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272883329",
            "telephone_number": "336-627-4854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN DRUG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "CROUCH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "336-627-4854"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0795443",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toni Mae Dunovant, PTA
• Javone Eaves, MBA, MS, LCMHCA, NCC
• Eckerd Corporation
• Eden Chiropractic
• Eden Drug Inc
• Eden Drug, Inc.
• Eden Health & Wellness Center
• Eden Internal Medicine PLLC
• Eden Internal Medicine PLLC
• Eden Opco LLC

• All providers in Eden, NC
• Long Term Care Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.