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General NPI Number Information
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NPI Number | 1043204902
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Entity Type | Organization
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Legal Business Name | COMMUNITY FAMILY PHARMACY
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 1194 WYKE RD
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City | SHELBY
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State | NC
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Zip | 28150-4259
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Country | US
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Telephone | 704-482-4457
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Fax | 704-487-5427
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Provider Business Mailing Address
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Address Line | 1194 WYKE RD
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City | SHELBY
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State | NC
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Zip | 28150-4259
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Country | US
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Telephone | 704-482-4457
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Fax | 704-487-5427
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Authorized Official
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Title or Position | OWNER
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Name | CARLA BEAM
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Credential |
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Telephone | 704-300-7197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 082000
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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