Organization
BEAM & PUTNAM INC.
Active
Other names
mossdrugstore
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS SHANE BARNES PHARMACIST (MANAGER)
(704) 867-9611
Entity
Organization
Contact information
Practice address
701 W FRANKLIN BLVD, GASTONIA, NC 28052-3830
(704) 867-9611
(704) 864-7466
Mailing address
701 W FRANKLIN BLVD, GASTONIA, NC 28052-3830
(704) 867-9611
(704) 864-7466
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
07051
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0366129
—
NC
Enumeration date
03/29/2007
Last updated
10/26/2009
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