Organization
CUSTOM CAR PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH ANNE MEADE KING PHARMD. (PRESIDENT)
(336) 289-9969
Entity
Organization
Contact information
Practice address
2500 BATTLEGROUND AVE STE C, GREENSBORO, NC 27408-4030
(336) 289-0074
(336) 286-6696
Mailing address
2500 BATTLEGROUND AVE STE C, GREENSBORO, NC 27408-4030
(336) 289-0074
(336) 286-6696
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
07732
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0417922
—
NC
01
—
07732
NC PHARMACY PERMIT NUMBER
NC
01
—
3438606
NCPDP NUMBER
NC
Enumeration date
09/16/2006
Last updated
03/07/2023
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