Organization
SOUTHERN PINES PRESCRIPTION SHOP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON MCCLAIN (PRESIDENT)
(910) 315-4445
Entity
Organization
Contact information
Practice address
300 MIDDLETON ST, ROBBINS, NC 27325
(910) 948-2921
(910) 948-3477
Mailing address
300 S MIDDLETON ST, P.O. BOX 548, ROBBINS, NC 27325-8407
(910) 948-2921
(910) 948-3477
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
10391
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164560009
—
NC
01
—
2123091
PK
—
Enumeration date
02/02/2007
Last updated
05/31/2018
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