Organization
OMNISALUS INC
Active
Other names
City pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ELVIS TANYI PHARM.D, MBA (PHARMACY DIRECTOR)
(919) 757-8290
Entity
Organization
Contact information
Practice address
3110 NEW BERN AVE STE 108, RALEIGH, NC 27610-1200
(919) 703-0717
(919) 703-0861
Mailing address
3110 NEW BERN AVE STE 108, RALEIGH, NC 27610-1200
(919) 703-0717
(919) 703-0861
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
19478
NC
3336C0003X
Community/Retail Pharmacy
Primary
13181
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167484
PK
—
Enumeration date
10/20/2016
Last updated
02/15/2018
Update your record
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