Healthcare Provider Details

I. General information

NPI: 1396264057
Provider Name (Legal Business Name): ANDREW JOSEPH OLMSTEAD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRENNER AVE
SALISBURY NC
28144-2515
US

IV. Provider business mailing address

4170 IVYDALE AVE SW
CONCORD NC
28027-9214
US

V. Phone/Fax

Practice location:
  • Phone: 704-638-9000
  • Fax:
Mailing address:
  • Phone: 704-953-6926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27283
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: