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General NPI Number Information
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NPI Number | 1932442514
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Entity Type | Organization
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Legal Business Name | COMMUNITY PHARMACY OF ALBEMARLE, LLC
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Dates
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Enumeration Date | 04/01/2013
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 1420 US HIGHWAY 52 N SUITE C
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City | ALBEMARLE
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State | NC
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Zip | 28001-2622
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Country | US
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Telephone | 704-982-9179
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Fax | 704-983-5557
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Provider Business Mailing Address
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Address Line | 1420 US HIGHWAY 52 N SUITE C
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City | ALBEMARLE
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State | NC
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Zip | 28001-2622
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Country | US
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Telephone | 704-982-9179
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Fax | 704-983-5557
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW C CASTELLOE
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Credential | RPH
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Telephone | 704-982-9179
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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 | 11501
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License Number State | NC
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