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General NPI Number Information
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NPI Number | 1295320026
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Entity Type | Individual
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Provider Name | JOSEPH FELICIANO
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Gender | Male
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 548 CC CAMP ROAD
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City | ELKIN
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State | NC
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Zip | 28621
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 127 GILDEN WAY
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City | MOORESVILLE
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State | NC
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Zip | 28115-5816
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Country | US
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Telephone | 631-504-1354
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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 | 30140
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License Number State | NC
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