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General NPI Number Information
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NPI Number | 1992819973
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Entity Type | Organization
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Legal Business Name | REDWINE HEALTH SERVICES LLC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | 308 WHITE OAK ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5434
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Country | US
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Telephone | 336-629-9666
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Fax | 336-625-0566
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Provider Business Mailing Address
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Address Line | 308 WHITE OAK ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5434
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Country | US
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Telephone | 336-629-9666
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Fax | 336-625-0566
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | JULIANNA PARRISH
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Credential |
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Telephone | 336-629-9666
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 12785
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License Number State | NC
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