| NPI | 1447529631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JAE BASS Pharmacy Manager 910-592-8444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 05533) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2011-12-19 |