Healthcare Provider Details

I. General information

NPI: 1366102790
Provider Name (Legal Business Name): CHARLOTTE MARIE ZIROLL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 BATTLEGROUND AVE
GREENSBORO NC
27410-9296
US

IV. Provider business mailing address

639 LAUREL ST
WINSTON SALEM NC
27101-5138
US

V. Phone/Fax

Practice location:
  • Phone: 336-288-2246
  • Fax:
Mailing address:
  • Phone: 989-255-1614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number30979
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: