Healthcare Provider Details

I. General information

NPI: 1710155486
Provider Name (Legal Business Name): MONIQUE L. ALFORD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 EAST THIRD STREET
PEMBROKE NC
28372
US

IV. Provider business mailing address

503 EAST THIRD STREET
PEMBROKE NC
28372
US

V. Phone/Fax

Practice location:
  • Phone: 910-521-0177
  • Fax: 910-521-0189
Mailing address:
  • Phone: 910-521-0177
  • Fax: 910-521-0189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17470
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: