Organization
SENIOR CARE PHARMACY LLC
Active
Organization
SENIOR CARE PHARMACY LLC
Active
Other names
Copper Creek Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL HOWARD (MANGER)
(704) 246-6510
Entity
Organization
Contact information
Practice address
1207 CREWS RD STE D, MATTHEWS, NC 28105-7582
(704) 246-6510
(704) 246-7775
Mailing address
1207 CREWS RD STE D, MATTHEWS, NC 28105-7582
(704) 246-6510
(704) 246-7775
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
10235
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0602342
—
NC
01
—
2119183
PK
—
Enumeration date
01/30/2009
Last updated
10/19/2016
Update your record
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