MEDICARE: MRS. ANN RECTOR SLADE PHARMACIST

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	183500000X	Pharmacist	6381	NC

General Provider Information

NPI Number	:	1437100476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANN RECTOR SLADE PHARMACIST

Provider Business Mailing Address
First Line	:	8300 N CRESTWYCK CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-3211
Country	:	US
Telephone Number	:	919-847-9911
Fax Number	:	919-715-7706

Provider Business Practice Location Address
First Line	:	2501 MAIL SERVICE CTR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27699-2501
Country	:	US
Telephone Number	:	919-647-8150
Fax Number	:	919-715-7706

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	07/08/2007

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