Healthcare Provider Details

I. General information

NPI: 1770956401
Provider Name (Legal Business Name): ANDREA SCHILIRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2015
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13845 CONLAN CIR
CHARLOTTE NC
28277-2705
US

IV. Provider business mailing address

13845 CONLAN CIR
CHARLOTTE NC
28277-2705
US

V. Phone/Fax

Practice location:
  • Phone: 704-544-2092
  • Fax:
Mailing address:
  • Phone: 704-544-2092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25428
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: