Organization
L
Active
Other names
FAIRBROOK CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KESSEL MD (OWNER)
(820) 327-4745
Entity
Organization
Contact information
Practice address
1985 STARTOWN RD, HICKORY, NC 28602-8307
(828) 328-1169
(828) 327-4756
Mailing address
1985 STARTOWN RD, HICKORY, NC 28602-8307
(828) 328-1169
(828) 327-4756
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05735
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0185942
—
NC
01
—
2068601
PK
—
05
—
7703179
—
NC
Enumeration date
08/01/2006
Last updated
09/29/2014
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