Organization
LAKE BRANDT PHARMACY, INC
Active
Other names
Lake Brandt Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA SPARKS BENFIELD R.PH. (PRESIDENT/OWNER)
(336) 643-2550
Entity
Organization
Contact information
Practice address
1007 NC HIGHWAY 150 W STE E, SUMMERFIELD, NC 27358-7925
(336) 643-2550
(336) 643-2115
Mailing address
1007 NC HIGHWAY 150 W STE E, SUMMERFIELD, NC 27358-7925
(336) 643-2550
(336) 643-2115
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
09907
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0416264
—
NC
01
—
3409100
NCPDP
NC
Enumeration date
06/26/2009
Last updated
06/26/2009
Update your record
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