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General NPI Number Information
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NPI Number | 1265963839
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Entity Type | Organization
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Legal Business Name | 786 PHARMACY INC
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 316 SOUTH MAIN STREET
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City | GRAHAM
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State | NC
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Zip | 27253
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Country | US
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Telephone | 336-227-2073
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Fax | 336-227-7401
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Provider Business Mailing Address
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Address Line | 316 S MAIN ST
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City | GRAHAM
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State | NC
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Zip | 27253-3320
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Country | US
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Telephone | 336-227-2093
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Fax | 336-227-7401
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOAZZAM A SHAIKH
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Credential | RPH
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Telephone | 919-724-6627
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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 | 13198
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License Number State | NC
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