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General NPI Number Information
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NPI Number | 1295110864
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Entity Type | Organization
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Legal Business Name | PIKE'S PHARMACY INC
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 2133 SHAMROCK DR
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City | CHARLOTTE
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State | NC
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Zip | 28205-2132
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Country | US
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Telephone | 704-563-2286
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Fax |
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Provider Business Mailing Address
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Address Line | 2133 SHAMROCK DR
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City | CHARLOTTE
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State | NC
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Zip | 28205-2132
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Country | US
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Telephone | 704-563-2286
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Fax |
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | JESSE MILLER PIKE JR.
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Credential | RPH
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Telephone | 704-563-2286
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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 | 04081
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License Number State | NC
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