Provider Demographics
NPI:1548253628
Name:BEST CARE PHARMACY OF CREEDMOOR, L.L.C.
Entity type:Organization
Organization Name:BEST CARE PHARMACY OF CREEDMOOR, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:919-603-0101
Mailing Address - Street 1:1614 NC HIGHWAY 56
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-8297
Mailing Address - Country:US
Mailing Address - Phone:919-529-0351
Mailing Address - Fax:919-529-0358
Practice Address - Street 1:1614 NC HIGHWAY 56
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-8297
Practice Address - Country:US
Practice Address - Phone:919-529-0351
Practice Address - Fax:919-529-0358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08460333600000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704157Medicaid
NC3441780OtherNABP
NC7704157Medicaid