Organization
WILSON FAMILY PHARMACIES INC
Active
Other names
Graham Drug Co
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN M WILSON RPH (OWNER)
(910) 285-8737
Entity
Organization
Contact information
Practice address
116 EAST MAIN ST, WALLACE, NC 28466
(910) 285-8737
(910) 285-8550
Mailing address
116 EAST MAIN ST, WALLACE, NC 28466
(910) 285-8737
(910) 285-8550
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
04948
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315218
—
NC
01
—
7703114
MEDICAID MCD
NC
Enumeration date
08/30/2006
Last updated
04/23/2012
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