| NPI | 1275066805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP AVERITT Pharmacist In Charge 336-379-1649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 08780) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |