Healthcare Provider Details

I. General information

NPI: 1619626983
Provider Name (Legal Business Name): ABIGAIL TAKACS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10730 PROVIDENCE RD
CHARLOTTE NC
28277-2683
US

IV. Provider business mailing address

10730 PROVIDENCE RD
CHARLOTTE NC
28277-2683
US

V. Phone/Fax

Practice location:
  • Phone: 704-845-2742
  • Fax:
Mailing address:
  • Phone: 704-845-2742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31229
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: