Provider Demographics
NPI:1992782643
Name:STANTONSBURG DRUG COMPANY, INC
Entity type:Organization
Organization Name:STANTONSBURG DRUG COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMIE
Authorized Official - Middle Name:ROWLAND
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:252-238-3539
Mailing Address - Street 1:105 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:STANTONSBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27883-0040
Mailing Address - Country:US
Mailing Address - Phone:252-238-3539
Mailing Address - Fax:252-238-2749
Practice Address - Street 1:105 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:STANTONSBURG
Practice Address - State:NC
Practice Address - Zip Code:27883-0040
Practice Address - Country:US
Practice Address - Phone:252-238-3539
Practice Address - Fax:252-238-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183500000X, 333600000X
NC04037332B00000X, 332BP3500X, 3336C0003X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0375NOtherBLUE CROSS-BLUE SHIELD NC
NC0985325Medicaid
NC7701130Medicaid
NC3401673OtherNABP NUMBER
NCAS3233116OtherDEA REGISTRATION NUMBER
NC3401673OtherNABP NUMBER