Healthcare Provider Details

I. General information

NPI: 1487740825
Provider Name (Legal Business Name): ELLON S. BARLOW RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 RAMSEY ST
FAYETTEVILLE NC
28301-3856
US

IV. Provider business mailing address

524 HARLOW DR
FAYETTEVILLE NC
28314-2615
US

V. Phone/Fax

Practice location:
  • Phone: 910-488-2120
  • Fax:
Mailing address:
  • Phone: 910-867-4846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5139
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: