Healthcare Provider Details

I. General information

NPI: 1912829086
Provider Name (Legal Business Name): ELEANNA KA FAUST PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8651 BRIER CREEK PKWY
RALEIGH NC
27617-7325
US

IV. Provider business mailing address

5120 ALSTON GLEN DR APT 344
CARY NC
27519-7657
US

V. Phone/Fax

Practice location:
  • Phone: 919-765-0006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34801
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: