Organization
MEDICAL PARK PHARMACY GREENVILLE, INC
Active
Other names
Medical Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN ANTHONY WICHER RPH (VP)
(252) 321-0222
Entity
Organization
Contact information
Practice address
1872 W ARLINGTON BLVD, SUITE M, GREENVILLE, NC 27834-5704
(252) 321-0222
(252) 321-0508
Mailing address
1872 W ARLINGTON BLVD, SUITE M, GREENVILLE, NC 27834-5704
(252) 321-0222
(252) 321-0508
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
11060
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0745961
—
NC
05
—
7704562
—
NC
Enumeration date
01/24/2013
Last updated
01/24/2013
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