| NPI | 1578826327 |
|---|---|
| Doing Business As | MEDSOURCE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DALTON ANGE R Ph/President 252-522-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 11293) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2015-02-24 |