MEDICARE: DR. LAUREN ELIZABETH BODE 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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	26287	NC
2	207Q00000X	Family Medicine Physician	26287	NC

General Provider Information

NPI Number	:	1376078592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN ELIZABETH BODE PHARMD

Provider Business Mailing Address
First Line	:	101 MANNING DR
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-4220
Country	:	US
Telephone Number	:	984-974-1711
Fax Number	:	984-974-7163

Provider Business Practice Location Address
First Line	:	590 MANNING DR
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-4220
Country	:	US
Telephone Number	:	919-966-2236
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2017
Last Update Date	:	07/21/2022

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