Healthcare Provider Details

I. General information

NPI: 1982911061
Provider Name (Legal Business Name): JUSTIN PATRICK LYNCH PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 12/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 E DIXIE DR
ASHEBORO NC
27203-8813
US

IV. Provider business mailing address

1107 E DIXIE DR
ASHEBORO NC
27203-8813
US

V. Phone/Fax

Practice location:
  • Phone: 336-629-7034
  • Fax: 336-626-6928
Mailing address:
  • Phone: 336-629-7034
  • Fax: 336-626-6928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21199
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: