Organization
COMMUNITY PHARMACY OF LINCOLNTON LLC
Active
Other names
the drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH A LONG (MANAGER)
(704) 735-2556
Entity
Organization
Contact information
Practice address
626 CENTER DR, LINCOLNTON, NC 28092-3712
(704) 735-2556
(704) 735-9045
Mailing address
626 CENTER DRIVE, LINCOLNTON, NC 28092-3712
(704) 735-2556
(704) 735-9045
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
05910
NC
3336C0003X
Community/Retail Pharmacy
Primary
05910
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7701534
—
NC
Enumeration date
07/20/2006
Last updated
12/19/2016
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