Provider Demographics
NPI:1730246562
Name:CASWELL CENTER
Entity type:Organization
Organization Name:CASWELL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:RITCHIE
Authorized Official - Middle Name:MURDOCK
Authorized Official - Last Name:APPLEWHITE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:252-208-4265
Mailing Address - Street 1:2415 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-3337
Mailing Address - Country:US
Mailing Address - Phone:252-208-4265
Mailing Address - Fax:252-208-4267
Practice Address - Street 1:2415 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-3337
Practice Address - Country:US
Practice Address - Phone:252-208-4265
Practice Address - Fax:252-208-4267
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASWELL DEVELOPMENTAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-02
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC029433336I0012X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408023Medicaid
NC3406105Medicaid