Healthcare Provider Details

I. General information

NPI: 1558715888
Provider Name (Legal Business Name): JODY CHEEK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 TROLLINGER ST
BURLINGTON NC
27215-2227
US

IV. Provider business mailing address

305 TROLLINGER ST
BURLINGTON NC
27215-2227
US

V. Phone/Fax

Practice location:
  • Phone: 336-226-1619
  • Fax: 336-226-1610
Mailing address:
  • Phone: 336-226-1619
  • Fax: 336-226-1610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12112
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: