Organization
MINTZ COASTAL DRUG STORE INC
Active
Other names
Coastal Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESA LOU MINTZ (PRESIDENT, MANAGER)
(910) 754-6563
Entity
Organization
Contact information
Practice address
4802 MAIN STREET, SHALLOTTE, NC 28470-1863
(910) 754-6563
Mailing address
PO BOX 70, SHALLOTTE, NC 28459-0070
(910) 754-6563
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
09293
NC
Other
Enumeration date
02/05/2007
Last updated
03/12/2013
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