Healthcare Provider Details

I. General information

NPI: 1114266590
Provider Name (Legal Business Name): MARY ABIGAIL SYKES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE STE 315
GREENSBORO NC
27401-1210
US

IV. Provider business mailing address

3001 E MARKET ST
GREENSBORO NC
27405-7525
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-4444
  • Fax: 336-832-4445
Mailing address:
  • Phone: 336-275-7657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number700704
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-165955
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21087
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: