| NPI | 1205137254 |
|---|---|
| Doing Business As | GLEN RAVEN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | AUGUST RICHARD PETERS Pharmacist/Manager 336-584-3736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 07468) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2010-11-08 |