Organization
COMMUNITY PHARMACY OF VALE LLC
Active
Other names
The Drug Store - Vale
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RICHARDS (OWNER/TREASURER)
(704) 904-3287
Entity
Organization
Contact information
Practice address
9576 NC HWY 10 W, VALE, NC 28168
(704) 462-0226
(704) 462-0229
Mailing address
9576 NC HWY 10 W, VALE, NC 28168
(704) 462-0226
(704) 462-0229
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
12064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0186299
—
NC
01
—
2147412
PK
—
Enumeration date
09/14/2006
Last updated
01/06/2015
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