| NPI | 1750789301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TROMBLEY Dispensing Physician 704-334-6488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NC 9400162) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |