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General NPI Number Information
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NPI Number | 1821195751
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Entity Type | Organization
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Legal Business Name | MEDI-SERVICE OF CHARLOTTE INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 610 E FRANKLIN ST
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City | MONROE
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State | NC
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Zip | 28112-5702
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Country | US
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Telephone | 704-289-1523
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Fax | 855-841-5354
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Provider Business Mailing Address
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Address Line | 610 E FRANKLIN ST
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City | MONROE
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State | NC
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Zip | 28112-5702
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Country | US
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Telephone | 704-289-1523
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Fax | 704-289-4758
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Authorized Official
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Title or Position | OWNER
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Name | ROBIN FLEISCHMAN
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Credential |
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Telephone | 704-516-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 11378
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License Number State | NC
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