Healthcare Provider Details

I. General information

NPI: 1356887384
Provider Name (Legal Business Name): JEREMY DALE EFIRD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2017
Last Update Date: 01/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 US HIGHWAY 13 S
AHOSKIE NC
27910-9481
US

IV. Provider business mailing address

2150 US HIGHWAY 13 S
AHOSKIE NC
27910-9481
US

V. Phone/Fax

Practice location:
  • Phone: 252-332-3545
  • Fax: 252-332-2753
Mailing address:
  • Phone: 252-332-3545
  • Fax: 252-332-2753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24102
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: