Healthcare Provider Details

I. General information

NPI: 1417240664
Provider Name (Legal Business Name): LAUREN APRIL KENNEDY CAUTHEN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 05/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 E BROAD AVE
ROCKINGHAM NC
28379-4902
US

IV. Provider business mailing address

1206 E BROAD AVE
ROCKINGHAM NC
28379-4902
US

V. Phone/Fax

Practice location:
  • Phone: 910-895-2453
  • Fax:
Mailing address:
  • Phone: 910-895-2453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15886
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: