1427124189 NPI number — NEWTON DRUG COMPANY LLC

Table of content: (NPI 1427124189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427124189 NPI number — NEWTON DRUG COMPANY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEWTON DRUG COMPANY LLC
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:
Provider Other Organization Name Type Code:
6
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:
1427124189
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 W A ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28658-3954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 W A ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28658-3954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-466-1500
Provider Business Practice Location Address Fax Number:
828-466-1502
Provider Enumeration Date:
11/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TRAVIS
Authorized Official First Name:
MELINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER PHARMACIST
Authorized Official Telephone Number:
828-466-1500

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  7639 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7703369 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3437767 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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