Healthcare Provider Details

I. General information

NPI: 1750692034
Provider Name (Legal Business Name): CECELIA M HOVIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 CENTRUM PKWY
PINEVILLE NC
28134-8809
US

IV. Provider business mailing address

10500 CENTRUM PKWY
PINEVILLE NC
28134-8809
US

V. Phone/Fax

Practice location:
  • Phone: 704-542-8644
  • Fax: 704-543-9116
Mailing address:
  • Phone: 704-542-8644
  • Fax: 704-543-9116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16382
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10139
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: