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General NPI Number Information
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NPI Number | 1821953878
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Entity Type | Organization
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Legal Business Name | MANOLOS PHARMACY
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 848 W 5TH ST
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City | WINSTON SALEM
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State | NC
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Zip | 27101-2506
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Country | US
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Telephone | 336-703-8738
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Fax | 336-232-1707
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Provider Business Mailing Address
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Address Line | 848 W 5TH ST
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City | WINSTON SALEM
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State | NC
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Zip | 27101-2506
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Country | US
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Telephone | 336-703-8738
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Fax | 336-232-1707
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Authorized Official
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Title or Position | CLINICAL PHARMACIST
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Name | MARY ANN COFFEY
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Credential | R.PH, CCN
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Telephone | 336-703-8738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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