| NPI | 1215018049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE DANA WALSER Insurance Coordinatore 704-687-0710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 261Q00000X (Licence: NC 4585) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2023-03-07 |