Indian Trail Pharmacy

LBN: Beam And Blizzard Llc
Indian Trail Pharmacy is an health care organization with primary practice located at 106 Indian Trail Rd S , Indian Trail NC 28079-9669. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Beam And Blizzard Llc can be contacted via phone (704) 821-7617, or through Devine, Terry via phone (704) 821-7617.

Contact Information

Primary practice address
106 Indian Trail Rd S Indian Trail NC 28079-9669
Fax: (704) 821-0177
Website:
Authorized official contact:
Name: Devine, Terry

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 11558 North Carolina
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1740374974
LBN Legal business name Beam And Blizzard Llc
DBA Doing business as Indian Trail Pharmacy
Authorized official Devine, Terry
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Nov 10th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740374974 NPPES
North Carolina MEDICAID 0905117
North Carolina Other 2140464

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