Organization
ROSEBORO PHARMACY INC
Active
Other names
Center Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WILSON (PHARMACY MANAGER/PRESIDENT)
(910) 285-8737
Entity
Organization
Contact information
Practice address
128 N CENTER ST, MOUNT OLIVE, NC 28365-1701
(919) 658-4313
(919) 658-4315
Mailing address
128 N CENTER ST, MOUNT OLIVE, NC 28365-1701
(919) 658-4313
(919) 658-4315
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
10585
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126541
PK
—
Enumeration date
09/20/2010
Last updated
08/10/2016
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