| NPI | 1629416557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY NOBLITT License Administrator 704-844-3418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2014-08-11 |