| NPI | 1073539920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE CANNON Director Of Pharmacy 251-476-4941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AL 120095) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2008-06-20 |