| NPI | 1407302383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN CLARK SQUIRES Pharmacist 910-891-1930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 26185) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-08-30 |