Organization
GASTON FAMILY HEALTH SERVICES INC
Active
Other names
Gaston Family Health Services Pharmacy at STLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN ALLEN (PHARMACY DIRECTOR)
(980) 322-4110
Entity
Organization
Contact information
Practice address
1875 REMOUNT RD, GASTONIA, NC 28054-7413
(704) 874-0617
(704) 866-7732
Mailing address
1875 REMOUNT RD, GASTONIA, NC 28054-7413
(704) 874-0617
(704) 866-7732
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
12096
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147948
PK
—
Enumeration date
09/18/2014
Last updated
01/30/2015
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