Organization
HAZELWOOD PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALDINE KEENUM JAMES (PHARMACIST MANAGER)
(828) 456-5481
Entity
Organization
Contact information
Practice address
429 HAZELWOOD AVE, HAZELWOOD, NC 28786-1946
(828) 456-5481
(828) 452-2120
Mailing address
PO BOX 247, HAZELWOOD, NC 28738-0247
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
04034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445049
—
NC
01
—
3407170
OTHER ID NUMBER
—
Enumeration date
03/13/2007
Last updated
09/12/2007
Update your record
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