Provider Demographics
NPI:1053988360
Name:A1 PHARMACY AND SURGICAL SUPPLY, LLC
Entity type:Organization
Organization Name:A1 PHARMACY AND SURGICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RAVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-328-4476
Mailing Address - Street 1:124 FOREST HILL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27295-2008
Mailing Address - Country:US
Mailing Address - Phone:336-224-6500
Mailing Address - Fax:336-224-6555
Practice Address - Street 1:124 FOREST HILL RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295-2008
Practice Address - Country:US
Practice Address - Phone:336-224-6500
Practice Address - Fax:336-224-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-06
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy