| NPI | 1225574536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARDIK PATEL Pharmacist In Charge 704-322-0593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: VA 0201004753) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-04-19 |