Provider Demographics
NPI:1144450933
Name:CAROLINA APOTHECARY INC
Entity type:Organization
Organization Name:CAROLINA APOTHECARY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:336-342-0071
Mailing Address - Street 1:726 S SCALES ST
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-5330
Mailing Address - Country:US
Mailing Address - Phone:336-342-0071
Mailing Address - Fax:336-394-1110
Practice Address - Street 1:726 S SCALES ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5330
Practice Address - Country:US
Practice Address - Phone:336-342-0071
Practice Address - Fax:336-394-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2801176AOtherCIGNA GOVERNMENT SERVICES
VA008501386Medicaid
NC0795542Medicaid