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General NPI Number Information
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NPI Number | 1538430012
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Entity Type | Organization
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Legal Business Name | SHARED PHARMACY HOLDINGS LLC
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Dates
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Enumeration Date | 01/16/2012
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 1196 PLEASANT RIDGE RD STE A-1
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City | GREENSBORO
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State | NC
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Zip | 27409-9753
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Country | US
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Telephone | 336-450-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 1196 PLEASANT RIDGE RD SUITE A-1
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City | GREENSBORO
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State | NC
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Zip | 27409-9753
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Country | US
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Telephone | 336-450-3900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAVEN PERKINS
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Credential |
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Telephone | 407-804-1836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 11446
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License Number State | NC
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