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General NPI Number Information
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NPI Number | 1386252229
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Entity Type | Individual
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Provider Name | DARRYL DEVON LEWIS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2020
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Last Update Date | 07/16/2020
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Provider Practice Location Address
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Address Line | 1150 REVOLUTION MILL DR
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City | GREENSBORO
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State | NC
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Zip | 27405-5085
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Country | US
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Telephone | 336-285-7985
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Fax |
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Provider Business Mailing Address
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Address Line | 639 S PIERCE ST APT H
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City | EDEN
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State | NC
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Zip | 27288-5875
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Country | US
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Telephone | 252-469-6529
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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 | 0202218236
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 29186
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License Number State | NC
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