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General NPI Number Information
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NPI Number | 1265854053
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Entity Type | Organization
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Legal Business Name | MEDISUITE
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 160 MACGREGOR PINES DR SUITE 110
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City | CARY
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State | NC
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Zip | 27511-6036
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Country | US
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Telephone | 919-200-6952
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Fax | 919-200-6951
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Provider Business Mailing Address
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Address Line | 160 MACGREGOR PINES DR SUITE 110
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City | CARY
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State | NC
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Zip | 27511-6036
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Country | US
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Telephone | 919-200-6952
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Fax | 919-200-6951
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Authorized Official
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Title or Position | CEO
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Name | RIKARD AKHTARZAND
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Credential |
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Telephone | 919-200-6952
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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 |
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License Number State |
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