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General NPI Number Information
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NPI Number | 1255019055
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Entity Type | Individual
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Provider Name | MADELINE MARSH PELHAM PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 1601 BRENNER AVENUE BUILDING 3, ROOM 4003
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City | SALISBURY
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State | NC
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Zip | 28144-2515
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Country | US
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Telephone | 912-536-3993
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 BRENNER AVENUE BUILDING 3, ROOM 4003
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City | SALISBURY
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State | NC
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Zip | 28144-2515
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 32273
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License Number State | NC
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