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General NPI Number Information
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NPI Number | 1407940042
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Entity Type | Organization
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Legal Business Name | CRESENT PHARMACY
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 314 E. MAIN ST.
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City | ROCKWELL
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State | NC
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Zip | 28138
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Country | US
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Telephone | 704-279-2288
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Fax | 704-279-0881
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Provider Business Mailing Address
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Address Line | PO BOX 489
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City | ROCKWELL
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State | NC
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Zip | 28138
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Country | US
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Telephone | 704-279-2288
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Fax | 704-279-0881
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Authorized Official
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Title or Position | MANAGER
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Name | MS. ANN GOODMAN
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Credential |
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Telephone | 704-279-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14232
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License Number State | NC
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