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General NPI Number Information
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NPI Number | 1598295784
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Entity Type | Organization
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Legal Business Name | TARHEEL TOWN PHARMACY, LLC
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 370 E MAIN ST STE 160
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City | CARRBORO
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State | NC
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Zip | 27510-1866
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Country | US
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Telephone | 919-904-6474
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Fax |
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Provider Business Mailing Address
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Address Line | 370 E MAIN ST STE 160
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City | CARRBORO
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State | NC
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Zip | 27510-1866
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Country | US
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Telephone | 919-904-6474
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MALLESHAPPA M BABA
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Credential |
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Telephone | 919-240-7827
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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 | 13276
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License Number State | NC
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