| NPI | 1679058077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS TODD ILLIG Pharmacy Manager 919-803-6417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2025-05-13 |