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General NPI Number Information
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NPI Number | 1699159467
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Entity Type | Organization
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Legal Business Name | JLOVE LLC (DBA ADLER PHARMACY)
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Dates
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Enumeration Date | 07/11/2015
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 3806 A NORTH CHURCH STREET
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City | GREENSBORO
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State | NC
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Zip | 27405
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Country | US
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Telephone | 336-897-3810
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Fax | 336-897-3811
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Provider Business Mailing Address
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Address Line | 1750 TIMBER COVE COURT
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City | WINSTON-SALEM
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State | NC
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Zip | 27127
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Country | US
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Telephone | 336-240-9137
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Fax | 336-897-3811
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. CLEMENT OSEMEKE EBHODAGHE
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Credential | BPHARM( RPH)
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Telephone | 336-240-9137
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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 | 12637
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License Number State | NC
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