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Organization

KERNERSVILLE PHARMACY LLC

Active
Other names
KERNERSVILLE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STANLEY OAKLEY WATTS RPH. (PHARMACIST)
(336) 497-4511
Entity
Organization

Contact information

Practice address
841 OLD WINSTON RD, STE 90, KERNERSVILLE, NC 27284-7144
(336) 497-4511
Mailing address
841 OLD WINSTON RD, STE 90, KERNERSVILLE, NC 27284-7144
(336) 497-4511

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10521
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0347780
NC
Enumeration date
11/18/2010
Last updated
11/18/2010
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