Organization
PIEDMONT PHARMACY LLC
Active
Other names
Piedmont Pharmacy, LLC of Charlotte
Organization subpart
No
Provider details
NPI number
Authorized official
TONY GURLEY (PHARMACY MANAGER)
(919) 215-0240
Entity
Organization
Contact information
Practice address
12610 N COMMUNITY HOUSE RD STE 100, CHARLOTTE, NC 28277-3892
(919) 865-4641
(919) 865-4644
Mailing address
PO BOX 90216, RALEIGH, NC 27675-0216
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
11164
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3459600
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/23/2011
Last updated
02/03/2012
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