Waters Drug Company LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10062 Issued in NC

Legal business name

WATERS DRUG COMPANY LLC

Doing business as

Waters Drug Company

Practice address

201 Livermore Dr
Pembroke, NC 28372-7322

Phone

(910) 522-5152

Fax

(910) 739-7207

NPI assigned

Mar 10, 2008

Last updated

Feb 11, 2015By 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

Wesley Waters, RPH

Title

Owner

Phone

(910) 691-1022

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WATERS DRUG COMPANY Doing business as

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1922278605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LIVERMORE DR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727322",
            "telephone_number": "910-522-5152",
            "fax_number": "910-522-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LIVERMORE DR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727322",
            "telephone_number": "910-522-5152",
            "fax_number": "910-739-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERS DRUG COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-691-1022",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10062",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2067270",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATERS DRUG COMPANY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• University of North Carolina at Pembroke Student Health Services
• University of North Carolina at Pembroke Student Health Services
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5489)
• Wal-Mart Stores, Inc (Vision Center 30-5489)
• Walgreen Co (Walgreens #16119)
• Jordan Michele Webb, COTA/L
• Lauren Werner, ATC, LAT
• West Primary Care, Inc
• West Primary-Urgent Care, PLLC
• West Winds Assisted Living

• Community/Retail Pharmacy in Pembroke, NC
• Providers in Pembroke, 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 Feb 11, 2015; 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.