| NPI | 1518259613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GADDY Pharmacy Manager 704-366-5684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 15937) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: SC 12325) |
| Enumeration Date | 2011-05-07 |
| Last Update Date | 2011-05-07 |