| NPI | 1568731594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN WELDON FULLER Vice President/ Pharmacist Manager 704-636-1712 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 05609) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2011-12-20 |