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General NPI Number Information
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NPI Number | 1811042476
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Entity Type | Organization
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Legal Business Name | TARHEEL PHARMACY #2 INC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1505 N ROAD ST
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3243
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Country | US
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Telephone | 252-384-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 N ROAD ST
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3243
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. AMANDA WHITEHEAD
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Credential | PHARM D, RPH
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Telephone | 252-384-1001
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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 | 09117
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License Number State | NC
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