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General NPI Number Information
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NPI Number | 1134480718
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Entity Type | Organization
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Legal Business Name | COUNTY OF CUMBERLAND OFFICE OF TREASURER
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 227 FOUNTAINHEAD LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-5488
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Country | US
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Telephone | 910-433-3861
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Fax | 910-433-3869
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Provider Business Mailing Address
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Address Line | 227 FOUNTAINHEAD LN SUITE #104
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-5488
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Country | US
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Telephone | 910-433-3861
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Fax | 910-433-3869
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | TAMI KEIBLER
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Credential |
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Telephone | 910-433-3897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 11291
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License Number State | NC
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