| NPI | 1164834867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK MONTE IGNACIO Pharmacist Manager 252-459-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: NC 11998) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: NC 11998) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |