Provider Demographics
NPI:1316422405
Name:CARY PHARMACY, LLC
Entity type:Organization
Organization Name:CARY PHARMACY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SRINIVASA
Authorized Official - Middle Name:K
Authorized Official - Last Name:NANDYALA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:919-678-5027
Mailing Address - Street 1:114 KILMAYNE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4465
Mailing Address - Country:US
Mailing Address - Phone:919-678-5027
Mailing Address - Fax:
Practice Address - Street 1:114 KILMAYNE DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4465
Practice Address - Country:US
Practice Address - Phone:760-821-5092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy