Healthcare Provider Details

I. General information

NPI: 1225306673
Provider Name (Legal Business Name): KIMBERLY KINTNER AILES PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2011
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 SHELTON AVE
STATESVILLE NC
28677-6826
US

IV. Provider business mailing address

200 E 2ND AVE
GASTONIA NC
28052-4358
US

V. Phone/Fax

Practice location:
  • Phone: 704-768-2081
  • Fax:
Mailing address:
  • Phone: 704-730-7003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18865
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: