Andersons Drug Store LLC
Organization Active NPI Community/Retail Pharmacy · Elizabethtown, NC
NPI 1255896015 · NPPES record last updated May 2, 2019
Key facts
- NPI
- 1255896015
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- ANDERSONS DRUG STORE LLC
- Practice address
- 206 S. Poplar St.
Elizabethtown, NC 28337 - Phone
- (910) 862-8411
- Fax
- (910) 862-8775
- NPI assigned
- Feb 6, 2019
- Organization subpart
- No
Authorized official
- Name
- Genese Anderson Peed, PHARM D
- Title
- Pharmacist/Owner
- Phone
- (910) 862-8411
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200814000124 | NC | Part B Supplier - Pharmacy | 8820331739 | Practice locations: Elizabethtown, NC |
National Provider Directory
Locations
206 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-8411
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
206 S. Poplar St.
Elizabethtown, NC 28337
Mailing address
PO Box 730
Elizabethtown, NC 28337-0730
Phone (910) 862-8411
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- Charles Davis Allen Jr.
- Stephanie B Alper
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- Richmond K Asante
- Megan Atkinson
- Amanda Denise Baker
- Bassem Barsoum
- Sueellen Baute
All providers in Elizabethtown, 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 May 2, 2019. 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.