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General NPI Number Information
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NPI Number | 1619125465
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Entity Type | Organization
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Legal Business Name | FCRX INC
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 3620 PROVIDENCE ROAD STE 100
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City | WAXHAW
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State | NC
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Zip | 28173
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Country | US
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Telephone | 704-451-5051
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Fax | 704-510-4311
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Provider Business Mailing Address
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Address Line | 9740B UNIVERSITY CITY BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28213-3608
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Country | US
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Telephone | 704-451-5051
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Fax | 704-510-4311
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANJAY PATEL
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Credential |
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Telephone | 704-451-5051
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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 | 10178
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License Number State | NC
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