Provider Demographics
NPI:1124854393
Name:CARROLL DRUG STORE INC
Entity type:Organization
Organization Name:CARROLL DRUG STORE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:W
Authorized Official - Last Name:NORBERG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:207-244-5588
Mailing Address - Street 1:PO BOX 1306
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04679-1306
Mailing Address - Country:US
Mailing Address - Phone:207-244-5588
Mailing Address - Fax:207-244-5718
Practice Address - Street 1:3 VILLAGE GREEN WAY
Practice Address - Street 2:
Practice Address - City:SOUTHWEST HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04679-4227
Practice Address - Country:US
Practice Address - Phone:207-244-5588
Practice Address - Fax:207-244-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy