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NPI Code Detail

MEDICARE: GINA HARRELL PHARMD

MEDICARE: GINA HARRELL 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
1183500000XPharmacist18097NC

General Provider Information

NPI Number : 1578873030
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA HARRELL PHARMD
Provider Business Mailing Address
First Line : 605 N MAIN ST
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-2026
Country : US
Telephone Number : 919-880-3564
Fax Number : 919-567-0015
Provider Business Practice Location Address
First Line : 605 N MAIN ST
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-2026
Country : US
Telephone Number : 919-880-3564
Fax Number : 919-567-0015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2010
Last Update Date : 10/19/2010

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