Healthcare Provider Details

I. General information

NPI: 1326977372
Provider Name (Legal Business Name): KENNETH ANDREWS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 KILDAIRE FARM RD
CARY NC
27518-6614
US

IV. Provider business mailing address

2080 KILDAIRE FARM RD
CARY NC
27518-6614
US

V. Phone/Fax

Practice location:
  • Phone: 919-858-9978
  • Fax: 919-858-9981
Mailing address:
  • Phone: 919-858-9978
  • Fax: 919-858-9981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number28992
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: