Healthcare Provider Details

I. General information

NPI: 1568964617
Provider Name (Legal Business Name): CAROL WU LAM-GARDNER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2018
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 APEX PEAKWAY
APEX NC
27502-5709
US

IV. Provider business mailing address

2406 WATERSGLEN DR
APEX NC
27502-6248
US

V. Phone/Fax

Practice location:
  • Phone: 919-362-3717
  • Fax:
Mailing address:
  • Phone: 309-533-4572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27559
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: