Individual
MR. IRVING LOUIS TRUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
173 OVERLOOK DR, WILMINGTON, NC 28411-9670
(215) 280-7603
Mailing address
5351 GINGERWOOD DR, WILMINGTON, NC 28405-3091
(910) 798-3259
(910) 798-3256
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21697
NC
183500000X
Pharmacist
28RI01994500
NJ
183500000X
Pharmacist
28RJ03098
NJ
183500000X
Pharmacist
RP030296L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164706743
PHARMACIST
NC
Enumeration date
09/30/2011
Last updated
02/24/2021
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