| NPI | 1407582729 |
|---|---|
| Doing Business As | UPSTREAM PHARMACY EDEN |
| Entity Type | Organization |
| Authorized Contact | JOHN RICHARD WHITE Director Of Pharmacy 336-509-5751 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |