| NPI | 1790446300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER H TYNDALL Accounting Technician Iii 252-636-4920 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-01-05 |