1912141623 NPI number — MARSHALL FAMILY PHARMACY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912141623 NPI number — MARSHALL FAMILY PHARMACY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARSHALL FAMILY PHARMACY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MARSHALL FAMILY PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912141623
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 MOUNTAIN VIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARS HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28754-9700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-649-0682
Provider Business Mailing Address Fax Number:
828-689-2681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5115 HWY 25-70
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARSHALL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28753-6448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-649-0682
Provider Business Practice Location Address Fax Number:
828-649-0684
Provider Enumeration Date:
04/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HARRON
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER, PHARMACY MANAGER
Authorized Official Telephone Number:
828-689-2667

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  10303 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com