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General NPI Number Information
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NPI Number | 1932213634
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Entity Type | Organization
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Legal Business Name | PHARMACEUTICAL SPECIALTIES INC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 756 TYVOLA RD STE 112A
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City | CHARLOTTE
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State | NC
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Zip | 28217-3535
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Country | US
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Telephone | 704-519-0617
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Fax |
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Provider Business Mailing Address
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Address Line | 756 TYVOLA RD STE 112A
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City | CHARLOTTE
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State | NC
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Zip | 28217-3535
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Country | US
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Telephone | 704-519-0617
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Fax |
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. KEITH SLEDGE
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Credential | R.PH
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Telephone | 704-519-0617
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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 | 07602
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License Number State | NC
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