SOUTHERN VILLAGE PHARMACY INC
NPI: 1033456371
· CHAPEL HILL, NC 27516
· Pharmacy
· NPI assigned 01/07/2013
$715.00
Total Medicaid Paid
Provider Details
| Authorized Official | LEAKE, EDWARD (OWNER/MANAGER) |
| NPI Enumeration Date | 01/07/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
25 |
$715.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0002A |
|
12 |
12 |
$715.00 |
| 91300 |
|
13 |
12 |
$0.00 |