| NPI | 1942812326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT BEAVERS Credentialing Manager 919-210-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336I0012X Pharmacy Institutional Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2023-05-24 |