| NPI | 1063970275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS WILLIAM BRICKLEY Vice President 336-228-6337 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2020-11-25 |