Healthcare Provider Details

I. General information

NPI: 1326609538
Provider Name (Legal Business Name): CAROLINE GORDON MCDANIEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 N WASHINGTON ST
SHELBY NC
28150-3862
US

IV. Provider business mailing address

1124 N WASHINGTON ST
SHELBY NC
28150-3862
US

V. Phone/Fax

Practice location:
  • Phone: 980-487-1148
  • Fax: 704-487-7753
Mailing address:
  • Phone: 864-490-4213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28791
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: