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General NPI Number Information
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NPI Number | 1669760104
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Entity Type | Individual
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Provider Name | MICHELLE SPAIN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 124 MONTLIEU AVE
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City | HIGH POINT
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State | NC
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Zip | 27262-4029
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Country | US
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Telephone | 336-881-1050
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Fax | 336-889-8818
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Provider Business Mailing Address
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Address Line | 20 BEARKLING PL
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City | GREENSBORO
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State | NC
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Zip | 27407-6394
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Country | US
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Telephone | 336-617-3192
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Fax | 336-889-8818
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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 | 19648
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License Number State | NC
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