Provider Demographics
NPI:1871532457
Name:HUDSON DISCOUNT DRUG
Entity type:Organization
Organization Name:HUDSON DISCOUNT DRUG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MCKINLEY
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-874-5100
Mailing Address - Street 1:PO BOX 816
Mailing Address - Street 2:721 MALCOLM BLVD.
Mailing Address - City:RUTHERFORD COLLEGE
Mailing Address - State:NC
Mailing Address - Zip Code:28671-0816
Mailing Address - Country:US
Mailing Address - Phone:828-874-5100
Mailing Address - Fax:828-874-2843
Practice Address - Street 1:721 MALCOLM BLVD
Practice Address - Street 2:
Practice Address - City:RUTHERFORD COLLEGE
Practice Address - State:NC
Practice Address - Zip Code:28671
Practice Address - Country:US
Practice Address - Phone:828-874-5100
Practice Address - Fax:828-874-2843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00961332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0779500002Medicare NSC