Organization
PHARMACY LAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA B LAND (OWNER)
(336) 635-6450
Entity
Organization
Contact information
Practice address
137 N FIELDCREST RD, EDEN, NC 27288-3947
(336) 635-6450
(336) 635-6540
Mailing address
137 N FIELDCREST RD, EDEN, NC 27288-3947
(336) 635-6450
(336) 635-6540
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
05651
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0795658
—
NC
Enumeration date
07/23/2006
Last updated
08/22/2020
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