Healthcare Provider Details

I. General information

NPI: 1548184203
Provider Name (Legal Business Name): SOPHIA FITZGERALD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 WELLNESS BLVD STE 110
MONROE NC
28110-7772
US

IV. Provider business mailing address

3015 UNIVERSITY RD
WINSTON SALEM NC
27104-4025
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-1140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33891
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: