| NPI | 1962704635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY FOWLER LOVETT Pharmicist 910-653-3089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: NC 00917) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |