Healthcare Provider Details

I. General information

NPI: 1942464540
Provider Name (Legal Business Name): ELIZABETH TRUMAN LOCKLEAR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2008
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 US HIGHWAY 117 S UNIT 110
ROCKY POINT NC
28457-7409
US

IV. Provider business mailing address

7910 US HIGHWAY 117 S UNIT 110
ROCKY POINT NC
28457-7409
US

V. Phone/Fax

Practice location:
  • Phone: 910-210-2030
  • Fax: 910-210-2031
Mailing address:
  • Phone: 910-210-2030
  • Fax: 910-210-2031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17313
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: