Healthcare Provider Details

I. General information

NPI: 1144451030
Provider Name (Legal Business Name): YORONDA ARTECIAH FORDE PHARMD, CPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 09/23/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4811 NC HWY 50
MAPLE HILL NC
28454-8153
US

IV. Provider business mailing address

4811 NC HWY 50
MAPLE HILL NC
28454-8153
US

V. Phone/Fax

Practice location:
  • Phone: 910-259-8880
  • Fax: 910-258-4144
Mailing address:
  • Phone: 910-259-8880
  • Fax: 910-259-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20434
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: