Provider Demographics
NPI:1104381276
Name:CENTRAL PHARMACY - CHARLOTTE LLC
Entity type:Organization
Organization Name:CENTRAL PHARMACY - CHARLOTTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-543-9990
Mailing Address - Street 1:354 S COCHRAN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1569
Mailing Address - Country:US
Mailing Address - Phone:517-543-9990
Mailing Address - Fax:
Practice Address - Street 1:354 S COCHRAN AVE STE 3
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1569
Practice Address - Country:US
Practice Address - Phone:517-543-9990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy