Healthcare Provider Details

I. General information

NPI: 1376579052
Provider Name (Legal Business Name): CHS PHARMACY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 CHURCH ST N
CONCORD NC
28025
US

IV. Provider business mailing address

PO BOX 603216
CHARLOTTE NC
28260-3216
US

V. Phone/Fax

Practice location:
  • Phone: 704-403-1568
  • Fax: 704-403-1784
Mailing address:
  • Phone: 704-512-7637
  • Fax: 704-512-7630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number12984
License Number StateNC

VIII. Authorized Official

Name: NICHOLAS COLE WILSON
Title or Position: AVP PHARMACY SERVICES
Credential:
Phone: 704-446-1404