Healthcare Provider Details

I. General information

NPI: 1144374489
Provider Name (Legal Business Name): TAMALA JANE HARTSELL RPH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

REMEDY SHOPPE PHARMACY 925-1 SUNSET COMMONS SEASIDE RD SW
OCEAN ISLE BEACH NC
28469
US

IV. Provider business mailing address

10987 FLOWES STORE RD
MIDLAND NC
28107-9419
US

V. Phone/Fax

Practice location:
  • Phone: 910-575-5030
  • Fax:
Mailing address:
  • Phone: 704-455-6651
  • Fax: 704-455-3651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10192
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: