Healthcare Provider Details

I. General information

NPI: 1659282416
Provider Name (Legal Business Name): HEIDI ROBERTS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 FORBES LOOP
GRANDY NC
27939-9625
US

IV. Provider business mailing address

123 FORBES LOOP
GRANDY NC
27939-9625
US

V. Phone/Fax

Practice location:
  • Phone: 252-453-8500
  • Fax:
Mailing address:
  • Phone: 252-453-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34880
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: