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General NPI Number Information
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NPI Number | 1235585662
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Entity Type | Organization
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Legal Business Name | ADVANCE COMMUNITY HEALTH, INC
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 1011 ROCK QUARRY RD
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City | RALEIGH
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State | NC
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Zip | 27610-3825
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Country | US
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Telephone | 919-755-5060
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Fax | 919-573-0041
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Provider Business Mailing Address
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Address Line | 1011 ROCK QUARRY RD
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City | RALEIGH
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State | NC
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Zip | 27610-3825
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Country | US
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Telephone | 919-755-5060
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Fax | 919-573-0041
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | TONCHELLE RENEE LUCAS
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Credential |
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Telephone | 919-250-2978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 13075
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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