| NPI | 1578228763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DENT Director Of Operations 336-210-6580 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2024-09-20 |