Healthcare Provider Details

I. General information

NPI: 1194551259
Provider Name (Legal Business Name): CAROLYN ANNETTE PAXTON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2816 ERWIN RD STE 105
DURHAM NC
27705-4589
US

IV. Provider business mailing address

2816 ERWIN RD STE 105
DURHAM NC
27705-4589
US

V. Phone/Fax

Practice location:
  • Phone: 919-282-5553
  • Fax: 919-864-4900
Mailing address:
  • Phone: 919-282-5553
  • Fax: 919-864-4900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33413
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: