Organization
LAKE ESCAPE INC
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL D SMITH RPH (OWNER)
(336) 222-9811
Entity
Organization
Contact information
Practice address
378 W HARDEN ST, BURLINGTON, NC 27215-7516
(336) 222-9811
Mailing address
378 W HARDEN ST, BURLINGTON, NC 27215-7516
(336) 222-9811
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5919
NC
Other
Enumeration date
10/06/2008
Last updated
10/06/2008
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