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General NPI Number Information
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NPI Number | 1184927162
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Entity Type | Organization
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Legal Business Name | OTWAY PHARMACY PARTNERS, INC
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 708 HIGHWAY 70 EAST - OTWAY
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City | BEAUFORT
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State | NC
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Zip | 28516
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Country | US
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Telephone | 252-717-9356
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Fax | 252-946-2095
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Provider Business Mailing Address
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Address Line | 708 HIGHWAY 70 EAST - OTWAY
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City | BEAUFORT
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State | NC
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Zip | 28516
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Country | US
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Telephone | 252-717-9356
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Fax | 252-946-2095
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | CHRISTY O POYTHRESS
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Credential | PHARM.D.
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Telephone | 252-717-9356
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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 | 10675
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License Number State | NC
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