Healthcare Provider Details

I. General information

NPI: 1629449111
Provider Name (Legal Business Name): BRITTANY BUMGARNER PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 10/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 CLEMMONS RD
CLEMMONS NC
27012-8725
US

IV. Provider business mailing address

3633 CLEMMONS RD
CLEMMONS NC
27012-8725
US

V. Phone/Fax

Practice location:
  • Phone: 828-455-1363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25221
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: