| NPI | 1659654200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH NORMAN TATUM Pharmacist In Charge 910-739-8144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 8804) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-09-20 |