Healthcare Provider Details

I. General information

NPI: 1467948935
Provider Name (Legal Business Name): STEPHEN MATTHEW HOHOL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2018
Last Update Date: 07/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2344 S CHURCH ST
BURLINGTON NC
27215-5332
US

IV. Provider business mailing address

2237 GLENKIRK DR
BURLINGTON NC
27215-9475
US

V. Phone/Fax

Practice location:
  • Phone: 336-227-7442
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25774
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: