Healthcare Provider Details

I. General information

NPI: 1841076775
Provider Name (Legal Business Name): JAMES ANDREW DAPELLO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10502 PARK RD STE 170
CHARLOTTE NC
28210-6490
US

IV. Provider business mailing address

10502 PARK RD STE 170
CHARLOTTE NC
28210-6490
US

V. Phone/Fax

Practice location:
  • Phone: 980-267-9990
  • Fax: 980-267-9991
Mailing address:
  • Phone: 980-267-9990
  • Fax: 980-267-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS66275
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: