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General NPI Number Information
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NPI Number | 1164729950
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Entity Type | Organization
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Legal Business Name | QUAIL CORNERS PHARMACY LLC
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 06/11/2011
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Provider Practice Location Address
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Address Line | 5039 FALLS OF NEUSE RD
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City | RALEIGH
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State | NC
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Zip | 27609-5462
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Country | US
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Telephone | 919-876-5020
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Fax | 919-876-5494
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Provider Business Mailing Address
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Address Line | 5039 FALLS OF NEUSE RD
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City | RALEIGH
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State | NC
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Zip | 27609-5462
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Country | US
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Telephone | 919-876-5020
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Fax | 919-876-5494
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | ROBERT DUAH-MENSAH
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Credential | PHARMACIST
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Telephone | 919-876-5020
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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 | 10937
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License Number State | NC
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