Organization
TALL OAKS PHARMACY
Active
Other names
TALL OAKS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY CARRUTH RPH (OWNER)
(704) 658-9814
Entity
Organization
Contact information
Practice address
798 OAK RIDGE FARM HWY, STE C, MOORESVILLE, NC 28115-7923
(704) 658-9814
(704) 658-0721
Mailing address
8703 STUDLEY RD STE B, MECHANICSVILLE, VA 23116-2016
(704) 658-9814
(704) 658-0721
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
09273
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497529
—
NC
01
—
3405520
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/14/2006
Last updated
09/10/2009
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