| NPI | 1124172119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL WAYNE CRADDOCK President Pharmacist 704-334-7286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NC 3601) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |