| NPI | 1033423348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLY WEASE Owner 704-913-7450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: SC 11125) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2010-10-01 |