Provider Information for 1033271002
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PHARMACY OF J IVERSON RIDDLE DEVELOPMENT CENTER
Other Names:Doing Business As:J IVERSON RIDDLE DEVELOPMENT CENTEROrganization Subpart: NO
NPI: 1033271002
Last Updated: 2024-03-07
Certification Date: 2024-03-07
Certification Date: 2024-03-07
Details
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NPI | 1033271002 | ||||||||||||||||||||
Enumeration Date | 2006-12-15 | ||||||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||||||
Status | Active | ||||||||||||||||||||
Authorized Official Information | Name: JANICE SWEARINGEN RPH Title: DIRECTOR OF PHCY SVCS Phone: 8284332683 | ||||||||||||||||||||
Mailing Address | CBO DHHS CONTROLLERS OFC 2021 MAIL SERVICE CENTER RALEIGH, NC 27699-0001 United States Phone: 919-733-9867 | Fax:919-733-1512 | ||||||||||||||||||||
Primary Practice Address | 300 ENOLA RD PHARMACY DEPARTMENT MORGANTON, NC 28655-4608 United States Phone: 828-433-2653 | Fax:828-433-2894 | ||||||||||||||||||||
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