Healthcare Provider Details

I. General information

NPI: 1245145309
Provider Name (Legal Business Name): DEMIANA DEMETRY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9870 REA RD
CHARLOTTE NC
28277-6655
US

IV. Provider business mailing address

4615 DAWNRIDGE DR
CHARLOTTE NC
28226-8064
US

V. Phone/Fax

Practice location:
  • Phone: 704-264-3521
  • Fax:
Mailing address:
  • Phone: 980-339-9144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34956
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: