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General NPI Number Information
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NPI Number | 1619264124
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Entity Type | Organization
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Legal Business Name | PRICE WELLNESS ENTERPRISES INCORPORATED
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 610 W MAIN ST
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City | ROCKWELL
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State | NC
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Zip | 28138-9414
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Country | US
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Telephone | 704-279-3001
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Fax | 704-279-3004
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Provider Business Mailing Address
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Address Line | 610 W MAIN ST
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City | ROCKWELL
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State | NC
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Zip | 28138-9414
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Country | US
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Telephone | 704-279-3001
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Fax | 704-279-3004
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Authorized Official
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Title or Position | OWNER
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Name | JASON PRICE
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Credential |
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Telephone | 980-875-1968
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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 | 11082
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License Number State | NC
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