FAMILY PHARMACY OF STATESVILLE, INC.

Durable Medical Equipment & Medical Supplies — Customized Equipment

Code: 332BC3200X

Pharmacy

Code: 333600000X

Pharmacy — Community/Retail Pharmacy

Code: 3336C0003X

Pharmacy — Compounding Pharmacy

Code: 3336C0004X

Pharmacy — Home Infusion Therapy Pharmacy

Code: 3336H0001X

Pharmacy — Long Term Care Pharmacy

Code: 3336L0003X