Organization
NEW TOWN CENTER PHARMACY INC
Active
Other names
TOWN CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMBASIVA R VENIGALLA (PRESIDENT)
(917) 541-8126
Entity
Organization
Contact information
Practice address
610 S BENNETT ST, SOUTHERN PINES, NC 28387-5920
(910) 692-7158
(910) 692-0748
Mailing address
610 S BENNETT ST, SOUTHERN PINES, NC 28387-5920
(910) 692-7158
(910) 692-0748
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10036
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0635409
—
NC
01
—
3411129
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
01/12/2010
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