Healthcare Provider Details

I. General information

NPI: 1437441268
Provider Name (Legal Business Name): LOU ELLA HURLEY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9925 ROSE COMMONS DR
HUNTERSVILLE NC
28078-3335
US

IV. Provider business mailing address

9925 ROSE COMMONS DR
HUNTERSVILLE NC
28078-3335
US

V. Phone/Fax

Practice location:
  • Phone: 704-875-2375
  • Fax: 704-875-2674
Mailing address:
  • Phone: 704-875-2375
  • Fax: 704-875-2674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11246
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: