Healthcare Provider Details

I. General information

NPI: 1811155807
Provider Name (Legal Business Name): SEGMIA KENNA TOHNYA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 09/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6602 KNIGHTDALE BLVD SUITE 120
KNIGHTDALE NC
27545-6525
US

IV. Provider business mailing address

6602 KNIGHTDALE BLVD SUITE 120
KNIGHTDALE NC
27545-6525
US

V. Phone/Fax

Practice location:
  • Phone: 919-295-1112
  • Fax: 919-295-1164
Mailing address:
  • Phone: 919-295-1112
  • Fax: 919-295-1164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH59907
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17668
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20223
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: