| NPI | 1619655297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONCHELLE RENEE LUCAS Credentialing Manager 919-250-2978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2025-02-25 |