Organization Name:  COOR'S PHARMACY, INC


Practice Location:
1103 WAYNE MEMORIAL DR  GOLDSBORO, NC 27534 US
Tel: 919-735-0400  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	332BP3500X	Suppliers Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition	NC	09270
N	332B00000X	Suppliers Durable Medical Equipment & Medical Supplies	NC	09270
N	335E00000X	Suppliers Prosthetic/Orthotic Supplier	NC	09270
Y	3336C0003X	Suppliers Pharmacy	NC	09270

Other Provider Identifiers:

Issuer	Number	State	Type
	7704425	NC	05
BCBS PROVIDER NUMBER	03900	NC	01
NABP	3429289	NC	01
	0965733	NC	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin