=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427912930
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAO COMMUNITY PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/10/2025
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 321 W 11TH ST
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28202-0092
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-237-8793
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 321 W 11TH ST
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28202-0092
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-237-8793
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO/DEPUTY DIRECTOR
-----------------------------------------------------
Name | AKEISHA EDWARDS
-----------------------------------------------------
Credential | J.D.
-----------------------------------------------------
Telephone | 917-562-3549
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------