Organization
TRIAD ADULT AND PEDIATRIC MEDICINE INC
Active
Other names
Triad Adult and Pediatric Med - GCH Wendover Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMY HALLISEY (PHARMACY DIRECTOR)
(336) 355-9908
Entity
Organization
Contact information
Practice address
1046 E WENDOVER AVE, GREENSBORO, NC 27405-6712
(336) 355-9908
(336) 275-1033
Mailing address
1046 E WENDOVER AVE, GREENSBORO, NC 27405-6712
(336) 355-9908
(336) 275-1033
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
11385
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137806
PK
—
05
—
344047B
—
NC
Enumeration date
11/06/2012
Last updated
06/18/2015
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