Healthcare Provider Details

I. General information

NPI: 1063460327
Provider Name (Legal Business Name): SHIRLEY LOW WAYPA PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRENNER AVE V.A. MEDICAL CENTER
SALISBURY NC
28144
US

IV. Provider business mailing address

475 COUNTRY LN
MOCKSVILLE NC
27028-8660
US

V. Phone/Fax

Practice location:
  • Phone: 704-638-9000
  • Fax:
Mailing address:
  • Phone: 336-751-3214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number13254
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: