Provider Demographics
NPI:1427105584
Name:BRISSON DRUGS INC
Entity type:Organization
Organization Name:BRISSON DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-865-4135
Mailing Address - Street 1:217 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAULS
Mailing Address - State:NC
Mailing Address - Zip Code:28384-1533
Mailing Address - Country:US
Mailing Address - Phone:910-865-4135
Mailing Address - Fax:910-865-3000
Practice Address - Street 1:217 W BROAD ST
Practice Address - Street 2:
Practice Address - City:SAINT PAULS
Practice Address - State:NC
Practice Address - Zip Code:28384-1533
Practice Address - Country:US
Practice Address - Phone:910-865-4135
Practice Address - Fax:910-865-3000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X, 3336L0003X
NC049273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2067482OtherPK
NC7700112Medicaid
NC0785485Medicaid
NC0785485Medicaid
NC0785485Medicaid