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REALO DISCOUNT DRUG STORES OF ENC INC NPI 1790111961


NPI Information

NPI: 1790111961
Provider Name: REALO DISCOUNT DRUG STORES OF ENC, INC

Doing Business As: REALO DISCOUNT DRUGS

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 34D2093892

Address:
5655 S NC 41 HWY
WALLACE, NC
ZIP 28466
Phone: (910) 285-1120
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REALO DISCOUNT DRUG STORES OF ENC, INC is a pharmacy in Wallace, NC. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. REALO DISCOUNT DRUG STORES OF ENC, INC NPI is 1790111961. The provider is registered as an organization entity type.
The provider Is Doing Business As Realo Discount Drugs.

The provider's business location address is:

5655 S NC 41 HWY
WALLACE, NC
ZIP 28466
Phone: (910) 285-1120
Fax: (910) 285-1124

The provider's authorized official is Robert Joseph Mclaughlin .
The authorized official title is President and has the following contact phone number (252) 639-9006.

The CLIA number assigned to this NPI record is 34D2093892 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2013 and was last updated on 12/21/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacy11618NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11790111961MEDICAIDNORTH CAROLINA
2C978OTHERNORTH CAROLINAMEDICARE FLU
34913000006MEDICARE NSCNORTH CAROLINA
411618OTHERNORTH CAROLINANCBOP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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