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
About Stedi
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