Organization
MIDELU INCORPORATED
Active
Other names
PLEASANT GARDEN DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRIFFIN PHARMD (PRESIDENT)
(336) 963-3317
Entity
Organization
Contact information
Practice address
4822 PLEASANT GARDEN RD, PLEASANT GARDEN, NC 27313-8253
(336) 674-5611
(336) 674-0995
Mailing address
2593 GREY RABBIT RUN, ASHEBORO, NC 27205-8097
(336) 857-1997
(866) 238-8879
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
10031
NC
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0415281
—
NC
01
—
2066637
PK
—
Enumeration date
06/11/2006
Last updated
12/08/2016
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