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General NPI Number Information
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NPI Number | 1316520455
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Entity Type | Organization
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Legal Business Name | LAXWOOD, LLC
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 3039 SOUTH BLVD STE F
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City | CHARLOTTE
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State | NC
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Zip | 28209-1866
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Country | US
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Telephone | 980-443-4910
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Fax | 980-999-5664
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Provider Business Mailing Address
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Address Line | 3039 SOUTH BLVD STE F
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City | CHARLOTTE
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State | NC
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Zip | 28209-1866
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Country | US
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Telephone | 980-443-4910
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VIPUL BHARATBHAI PATEL
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Credential | PHARMD
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Telephone | 980-443-4910
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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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