| NPI | 1750890109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON HURLEY Owner 336-625-8650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NC 13334) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 13334) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2022-07-21 |