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General NPI Number Information
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NPI Number | 1457662900
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Entity Type | Individual
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Provider Name | MAMIE WEBER GAVER RPH
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Gender | Female
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 10500 CENTRUM PKWY
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City | PINEVILLE
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State | NC
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Zip | 28134-8809
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Country | US
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Telephone | 704-542-8644
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Fax | 704-543-9116
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Provider Business Mailing Address
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Address Line | 23 HAMILTONS FERRY RD
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City | CLOVER
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State | SC
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Zip | 29710
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Country | US
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Telephone | 709-998-7956
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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 | 18465
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License Number State | NC
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