34D2232094 CLIA NUMBER - RED SPRINGS OLD MAIN PHARMACY

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Laboratory Demographics

CLIA Number: 34D2232094

Facility Name: RED SPRINGS OLD MAIN PHARMACY

Facility Address:
300 SOUTH MAIN STREET
RED SPRINGS, NC
ZIP 28377
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Facility Phone Number: 910 227-2425

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1073962718

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	34D2232094
LAB Type	Pharmacy
Facility Name	RED SPRINGS OLD MAIN PHARMACY
Street	300 SOUTH MAIN STREET
City	RED SPRINGS
State	NC
ZIP	28377
Phone	910 227-2425
CertificateType	4
CertificateEffectiveDate	8/10/2023
CertificateExpirationDate	8/9/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024