Organization
MEDICAL PARK PHARMACY GREENVILLE, INC
Active
Other names
Medical Park Pharmacy South
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WILLIAMS (PRESIDENT)
(252) 726-0777
Entity
Organization
Contact information
Practice address
4814 OLD TAR RD, WINTERVILLE, NC 28590-7852
(252) 752-8800
(252) 752-8808
Mailing address
4814 OLD TAR RD, WINTERVILLE, NC 28590-7852
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10208
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3413224
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/23/2008
Last updated
03/13/2009
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