Provider Demographics
NPI:1649693359
Name:OFFICE PRACTICE OF PHARMACY LLC
Entity type:Organization
Organization Name:OFFICE PRACTICE OF PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:F
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:828-632-8591
Mailing Address - Street 1:24 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-6524
Mailing Address - Country:US
Mailing Address - Phone:828-632-8591
Mailing Address - Fax:828-635-0529
Practice Address - Street 1:24 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681-6524
Practice Address - Country:US
Practice Address - Phone:828-632-8591
Practice Address - Fax:828-635-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10269332B00000X, 332BC3200X, 3336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1649693359Medicaid
NC1649693359Medicaid