Healthcare Provider Details

I. General information

NPI: 1972508620
Provider Name (Legal Business Name): KATHERINE FARMER POOLE PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N ARENDELL AVE
ZEBULON NC
27597-2605
US

IV. Provider business mailing address

315 COMMANDER DR
WENDELL NC
27591-8830
US

V. Phone/Fax

Practice location:
  • Phone: 919-269-7481
  • Fax: 919-269-9998
Mailing address:
  • Phone: 919-366-2178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13014
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: