Provider Demographics
NPI:1194737734
Name:MEDICINE BOX PHARMACY INC
Entity type:Organization
Organization Name:MEDICINE BOX PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:828-245-1696
Mailing Address - Street 1:664 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-4247
Mailing Address - Country:US
Mailing Address - Phone:828-245-1696
Mailing Address - Fax:828-245-3890
Practice Address - Street 1:664 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-4247
Practice Address - Country:US
Practice Address - Phone:828-245-1696
Practice Address - Fax:828-245-3890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0414KOtherBLUE CROSS BLUE SHIELD
NC7700233Medicaid
NC3418399OtherNABP
NC0815357Medicaid
NC3418399OtherNABP