Organization
NALLE PHARMACY INC
Active
Other names
Mint Hill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CARL DAGENHART (OWNER)
(704) 342-8180
Entity
Organization
Contact information
Practice address
11304 HAWTHORNE DR, STE 120, MINT HILL, NC 28227-9300
(704) 545-9687
(704) 545-1823
Mailing address
11304 HAWTHORNE DR, STE 120, MINT HILL, NC 28227-9300
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10181
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3412905
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/23/2008
Last updated
04/06/2009
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