Healthcare Provider Details

I. General information

NPI: 1447061429
Provider Name (Legal Business Name): MADISON MILLER CAULDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S 401 BYPASS HWY
LAURINBURG NC
28352-5089
US

IV. Provider business mailing address

167 FAIRWAY DR
ROCKINGHAM NC
28379-9484
US

V. Phone/Fax

Practice location:
  • Phone: 910-277-7771
  • Fax:
Mailing address:
  • Phone: 910-461-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33612
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: