Organization
GROWING CHILD PEDIATRICS, PA
Active
Other names
GCP Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEAN MATHEWS ENOCHS PHARMD (PHARMACY MANAGER)
(919) 741-9014
Entity
Organization
Contact information
Practice address
11130 CAPITAL BLVD, WAKE FOREST, NC 27587
(919) 488-4094
Mailing address
11130 CAPITAL BLVD, WAKE FOREST, NC 27587
(919) 488-4094
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
11756
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141143
PK
—
Enumeration date
01/03/2014
Last updated
01/14/2014
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