| NPI | 1225070675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM STAFFORD Pharmacy Manager 336-593-5329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: NC 05468) |
| Additional Taxonomies | 3336I0012X Pharmacy Institutional Pharmacy |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2010-06-02 |