Organization
SOUTHERN PINES PRESCRIPTION SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON PATRICK MCCLAIN (OWNER)
(910) 692-7467
Entity
Organization
Contact information
Practice address
1902 N SANDHILLS BLVD STE B, ABERDEEN, NC 28315-2347
(910) 692-7467
Mailing address
1902 N SANDHILLS BLVD STE B, ABERDEEN, NC 28315-2347
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
07585
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703459
—
NC
Enumeration date
11/29/2006
Last updated
08/22/2020
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