Healthcare Provider Details

I. General information

NPI: 1588875496
Provider Name (Legal Business Name): CHRISTY W WHITLEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 EASY ST
GREENVILLE NC
27834
US

IV. Provider business mailing address

PO BOX 532 7420 WOODBRIDGE ROAD
STANTONSBURG NC
27883-0532
US

V. Phone/Fax

Practice location:
  • Phone: 252-413-0063
  • Fax: 252-413-0646
Mailing address:
  • Phone: 252-413-0063
  • Fax: 252-413-0646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number11058
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: