Healthcare Provider Details

I. General information

NPI: 1942125661
Provider Name (Legal Business Name): MASON JAMES LAUDERMILCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3573 HILLSBOROUGH RD
DURHAM NC
27705-2916
US

IV. Provider business mailing address

1022 NORTHCREEK DR
DURHAM NC
27707-3367
US

V. Phone/Fax

Practice location:
  • Phone: 919-383-0171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34934
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: