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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
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