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General NPI Number Information
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NPI Number | 1811583552
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Entity Type | Organization
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Legal Business Name | PPAD3, LLC
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 3 N MAIN ST
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City | WEAVERVILLE
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State | NC
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Zip | 28787-9427
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Country | US
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Telephone | 828-484-7800
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Fax | 828-484-8956
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Provider Business Mailing Address
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Address Line | 3 N MAIN ST
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City | WEAVERVILLE
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State | NC
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Zip | 28787-9427
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Country | US
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Telephone | 828-484-7800
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Fax | 828-484-8956
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Authorized Official
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Title or Position | CO-OWNER
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Name | MICHAEL COLE HERRELL
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Credential | PHARMD
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Telephone | 828-446-4595
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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 |
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License Number State |
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