Pharmaceutical companies in North Carolina: fewer plants than most states, and some of the biggest

This report is for job seekers, suppliers and contract partners, and sellers who need to know where North Carolina's drug companies are and how big they are. It uses Census Bureau counts for plants, FDA's registration file for named sites and each listed company's 10-K for headquarters, revenue and headcount.

How North Carolina's plants compare

County Business Patterns (CBP) 2023, NAICS 3254 (Pharmaceutical and Medicine Manufacturing):

Every size class is published for North Carolina. Thirty establishments have 100 or more employees, against 29 with fewer than 20. By product, 41 establishments make finished-dose pharmaceuticals (325412, 16,424 employees) and 22 make biological products such as vaccines, plasma proteins and gene therapies (325414, 6,028 employees); 12 make medicinal chemicals and botanicals, and 3 make diagnostic substances.

What the plant count leaves out

Each CBP establishment is one location with a payroll, so a company with three plants counts three times; the self-employed aren't counted. Code 3254 covers manufacturing only. Research labs, head offices and distributors are classed elsewhere, and in North Carolina they're large: the same 2023 data shows 252 biotechnology R&D establishments (NAICS 541714) with 7,031 employees and 230 drug wholesale establishments (NAICS 424210) with 8,031.

Counties: published and hidden

"Not reported" means the Census Bureau published the total but flagged it as high-noise: its confidentiality noise moved the value by 5% or more. These eight counties hold 47 of the 78 establishments. The other 31 are in counties with one or two plants each, which the Census Bureau doesn't publish (it releases a county cell only when it holds three or more establishments). FDA's file shows where many of them are: Johnston County (Clayton), Lee County (Sanford), Rocky Mount, Cabarrus County (Concord) and McDowell County (Marion).

The big registered sites

FDA's Drug Establishments Current Registration Site (DECRS) lists 233 registered drug establishments in North Carolina in our count of the 30 October 2026 download: 104 that make finished drugs or active ingredients, 50 medical gas suppliers (our classification by firm name), 32 medicated animal feed mills, 27 packers or relabelers, 16 testing labs and 4 others. Durham (31) and Morrisville (17) have the most. The largest manufacturing names, by town:

The filings fill in a few of these. Pfizer's 2025 10-K says its Rocky Mount plant, damaged by a tornado in July 2023, "is responsible for manufacturing nearly 25 percent of all our sterile injectables." Lilly's 10-K names North Carolina among its major US production states. United Therapeutics gives a second principal executive office at 55 T.W. Alexander Drive, Durham. Registration is self-reported and isn't an FDA approval.

Listed drugmakers headquartered in North Carolina

SEC EDGAR shows 13 listed companies in SIC codes 2833 to 2836 with a North Carolina business address; TG Therapeutics, which EDGAR still files under New York, gives Morrisville on its latest 10-K. Checked in each 10-K:

The rest are small: vTv Therapeutics in High Point (26 employees), Tenax Therapeutics in Chapel Hill and Adaptin Bio in Charlotte. The global owners of the big plants rank in the largest pharmaceutical companies.

Checking a North Carolina company

• Distributor licence. FDA lists the North Carolina Department of Agriculture and Consumer Services, not the pharmacy board, as the agency that licenses wholesale drug distributors in the state.
• Inspection history. FDA's Data Dashboard shows inspections, warning letters and recalls by site.
• Training and hiring routes. The state Commerce Department lists the BTEC biomanufacturing center at NC State and the BRITE institute at North Carolina Central University among its training programs.
• The network. NCLifeSci, the state's life sciences trade association, has a member directory and an events calendar.

Prospecting North Carolina plants

Worked example: a calibration lab

Illustrative example. The lab and its prices are invented; the counts come from CBP 2023.

Piedmont Metrology (piedmontmetrology.example) calibrates balances, pipettes, temperature sensors and other instruments under GMP.

1. Pick the tier. The 23 plants with 100 to 999 employees run enough instruments to outsource calibration but often lack an in-house team.
2. Map the drive. Durham, Wake, Johnston, Pitt and Wilson counties, where FDA's file shows many of the big sites, are all within two hours of Raleigh.
3. Do the arithmetic. If 30% of the 23 take a quote (7) and 4 sign at $55,000 a year each, that's $220,000 of recurring work, plus audit-driven extras.

Finding the metrology or quality lead at each plant is the slow part; Bebop researches each account and suggests who to contact.

Next step: zoom in on Wake and Johnston counties in the Raleigh pharmaceutical market report.