Organization
MEDICAL PARK PHARMACY GREENVILLE
Active
Other names
MEDICAL PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN WICHER (VICE PRESIDENT)
(252) 726-0777
Entity
Organization
Contact information
Practice address
1872 W ARLINGTON BLVD, STE M, GREENVILLE, NC 27834-5704
(252) 321-0222
(252) 321-0508
Mailing address
1872 W ARLINGTON BLVD, STE M, GREENVILLE, NC 27834-5704
(252) 321-0222
(252) 321-0508
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
09288
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0745961
—
NC
01
—
2065833
PK
—
Enumeration date
05/23/2006
Last updated
01/20/2017
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