Organization
PRESCRIPTION SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON MCCLAIN (PRESIDENT)
(910) 215-0306
Entity
Organization
Contact information
Practice address
105 AVIEMORE DR # A, PINEHURST, NC 28374-9749
(910) 215-0306
(910) 215-5802
Mailing address
PO BOX 235, PINEHURST, NC 28370-0235
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
09504
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3407930
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
04/06/2007
Last updated
08/22/2020
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