Healthcare Provider Details

I. General information

NPI: 1497390579
Provider Name (Legal Business Name): LAUREN B CRIBB PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 W BROAD ST
SAINT PAULS NC
28384-1533
US

IV. Provider business mailing address

217 W BROAD ST
SAINT PAULS NC
28384-1533
US

V. Phone/Fax

Practice location:
  • Phone: 910-865-4135
  • Fax: 910-865-3000
Mailing address:
  • Phone: 910-865-4135
  • Fax: 910-865-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29310
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: