| NPI | 1548229933 |
|---|---|
| Doing Business As | MEDSOURCE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DALTON ANGE Pres 252-522-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 04233) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2016-03-31 |