| NPI | 1639501166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY MARTIN LONG CFO 919-833-7526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NC 05376) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2022-03-13 |