Dickersons Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

04491 Issued in NC

Legal business name

DICKERSONS PHARMACY INC

Doing business as

Dickersons Pharmacy Inc

Practice address

503 Doctors Dr
Elizabethtown, NC 28337

Phone

(910) 862-3465

Fax

(910) 862-4917

NPI assigned

Dec 27, 2006

Last updated

Jan 18, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bruce Dickerson, RPH

Title

Pres

Phone

(910) 862-3465

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• DICKERSONS PHARMACY INC Doing business as

Locations

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1871658039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 DOCTORS DR",
            "address_2": "PO BOX 426",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 DOCTORS DR",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-3465",
            "fax_number": "910-862-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKERSONS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "910-862-3465",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "04491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095182",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2065838",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7701212",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DICKERSONS PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cumberland County Hospital System Inc (CFV Foot and Ankle Center)
• Evelyn Rene Delieto, MA, CCC-SLP
• Jackie G Dennis, RN
• Toni H. Devane, RDN
• Breana Zhane Danielle Dickens, LCSWA
• Direccare Behavioral Services
• Direccare Behavioral Services, Inc
• Direccare Behavioral Services, Inc.
• Direccare Behavioral Services,Inc
• Dreamworks Therapeutic Learning Center

• Community/Retail Pharmacy in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.