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General NPI Number Information
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NPI Number | 1043350804
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Entity Type | Organization
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Legal Business Name | COMMUNITY PHARMACY OF GRANITE FALLS, LLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 21 FALLS AVE
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City | GRANITE FALLS
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State | NC
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Zip | 28630
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Country | US
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Telephone | 828-396-2144
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Fax | 828-396-9561
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Provider Business Mailing Address
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Address Line | 21 FALLS AVE
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City | GRANITE FALLS
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State | NC
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Zip | 28630
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Country | US
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Telephone | 828-396-2144
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Fax | 828-396-9561
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Authorized Official
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Title or Position | OWNER & PIC
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Name | BRYAN HUFFSTETLER
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Credential | PHARMD
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Telephone | 828-396-2144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 02793
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13303
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License Number State | NC
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