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NPI Code Detail

MEDICARE: DR. MALLORY DIANE LAMBETH HOWARD PHARMD

MEDICARE:  DR. MALLORY DIANE LAMBETH HOWARD  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist24111NC
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist24111NC

General Provider Information

NPI Number : 1033524087
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MALLORY DIANE LAMBETH HOWARD PHARMD
Provider Business Mailing Address
First Line : 5-4257 BASTOGNE ST
Second Line :
City : FORT BRAGG
State : NC
Zip : 28310-0001
Country : US
Telephone Number : 910-907-9791
Fax Number : 910-907-9606
Provider Business Practice Location Address
First Line : 5-4275 BASTOGNE EXT
Second Line :
City : FORT LIBERTY
State : NC
Zip : 28310-3424
Country : US
Telephone Number : 910-907-9791
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2014
Last Update Date : 08/25/2023

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