Organization
FAYETTEVILLE FAMILY MEDICAL CARE, PA
Active
Other names
Fayetteville Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICE M KUGLER (ADMINISTRATOR)
(910) 323-1718
Entity
Organization
Contact information
Practice address
1307 AVON ST, FAYETTEVILLE, NC 28304-4423
(910) 323-1718
(910) 323-3834
Mailing address
1307 AVON ST, FAYETTEVILLE, NC 28304-4423
(910) 323-1718
(910) 323-3834
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
07787
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048YU
BCBS
NC
Enumeration date
03/09/2012
Last updated
03/09/2012
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