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General NPI Number Information
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NPI Number | 1639454721
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Entity Type | Individual
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Provider Name | VALERIE RYDBERG COLE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 2912 MAIN ST
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City | WALKERTOWN
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State | NC
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Zip | 27051-9324
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Country | US
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Telephone | 336-595-2638
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Fax |
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Provider Business Mailing Address
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Address Line | 103 BURROW CT
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City | LEXINGTON
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State | NC
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Zip | 27295-9087
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Country | US
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Telephone | 919-455-4849
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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 | 21822
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License Number State | NC
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