Organization
OLD MONROE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN SHIELDS (PHARMACY MANAGER)
(704) 301-4651
Entity
Organization
Contact information
Practice address
4514 OLD MONROE RD STE A, INDIAN TRAIL, NC 28079-5308
(704) 831-7895
Mailing address
4514 OLD MONROE RD STE A, INDIAN TRAIL, NC 28079-5308
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
07/24/2022
Last updated
09/30/2024
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