Healthcare Provider Details

I. General information

NPI: 1891289682
Provider Name (Legal Business Name): JUNE LENNON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1381 WESTGATE CENTER DR
WINSTON SALEM NC
27103-2934
US

IV. Provider business mailing address

7825 WEST RD
WALNUT COVE NC
27052-9529
US

V. Phone/Fax

Practice location:
  • Phone: 855-307-6868
  • Fax: 336-718-8994
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9086
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: