Organization
CVS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN EDGE PHARMD (PHARMACY SUPERVISOR)
(910) 822-3535
Entity
Organization
Contact information
Practice address
100 LAW RD, FAYETTEVILLE, NC 28311-2716
(910) 822-3535
Mailing address
100 LAW RD, FAYETTEVILLE, NC 28311-2716
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
25760
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0265504
—
NC
Enumeration date
10/17/2016
Last updated
10/17/2016
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