| NPI | 1902821630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA RICHARDSON VP Managed Health 704-631-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WI 9453) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2025-01-30 |