Healthcare Provider Details

I. General information

NPI: 1285766014
Provider Name (Legal Business Name): DEANNA MARIE HOMER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E WENDOVER AVE STE 121
GREENSBORO NC
27401-1229
US

IV. Provider business mailing address

300 E WENDOVER AVE STE 121
GREENSBORO NC
27401-1229
US

V. Phone/Fax

Practice location:
  • Phone: 336-790-4385
  • Fax:
Mailing address:
  • Phone: 336-790-4385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26707
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2005007712
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS47257
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: