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
Phone: (704) 821-7617
Fax: (704) 821-0177
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740374974 | NPPES |
| North Carolina | MEDICAID | 0905117 | |
| North Carolina | Other | 2140464 |
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