| NPI | 1316483472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JELANI DAVIS PIC/Authorized Signatory 704-307-4580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NC 13147) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |