| NPI | 1942226097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY STEPHEN JARED Manager Owner 252-442-8159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 02429) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: NC 02429) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2008-04-16 |