Healthcare Provider Details

I. General information

NPI: 1316232416
Provider Name (Legal Business Name): HILLSBOROUGH PHARMACY & NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BOONE SQUARE ST STE 29
HILLSBOROUGH NC
27278-2665
US

IV. Provider business mailing address

110 BOONE SQUARE ST STE 29
HILLSBOROUGH NC
27278-2665
US

V. Phone/Fax

Practice location:
  • Phone: 919-245-1212
  • Fax: 919-245-1210
Mailing address:
  • Phone: 919-245-1212
  • Fax: 919-245-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number11064
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY BARBER
Title or Position: PHARMACY MANAGER/OWNER
Credential: PHARMD
Phone: 919-245-1212