| NPI | 1124696521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT WALKER TALLEY Owner 919-619-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-23 |