MEDICARE: LOTTIE ZHEVONDA JOHNSON PHARM.D.

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	17821	NC

General Provider Information

NPI Number	:	1851683593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOTTIE ZHEVONDA JOHNSON PHARM.D.

Provider Business Mailing Address
First Line	:	5920 CAROLINA BEACH RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-3364
Country	:	US
Telephone Number	:	910-796-3283
Fax Number	:

Provider Business Practice Location Address
First Line	:	5920 CAROLINA BEACH RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-3364
Country	:	US
Telephone Number	:	910-796-3283
Fax Number	:

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

Provider Enumeration Date	:	05/13/2011
Last Update Date	:	05/13/2011

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