Provider Demographics
NPI:1902807175
Name:DOVER-WEATHERS, INC.
Entity Type:Organization
Organization Name:DOVER-WEATHERS, INC.
Other - Org Name:PROFESSIONAL PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:704-263-9019
Mailing Address - Street 1:221 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-1930
Mailing Address - Country:US
Mailing Address - Phone:704-263-9019
Mailing Address - Fax:704-263-9093
Practice Address - Street 1:221 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:NC
Practice Address - Zip Code:28164-1930
Practice Address - Country:US
Practice Address - Phone:704-263-9019
Practice Address - Fax:704-263-9093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0365569Medicaid
NC0365569Medicaid