| NPI | 1841724127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID NATHANIEL WILLIAMS Pharmacist 704-200-5148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NC 26364) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2017-04-13 |