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General NPI Number Information
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NPI Number | 1710439682
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Entity Type | Individual
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Provider Name | ANITHA MATHEW
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Gender | Female
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 215 WILLIAMSBORO ST
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City | OXFORD
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State | NC
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Zip | 27565-3330
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Country | US
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Telephone | 919-693-8801
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Fax | 919-693-2401
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Provider Business Mailing Address
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Address Line | 215 WILLIAMSBORO ST
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City | OXFORD
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State | NC
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Zip | 27565-3330
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Country | US
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Telephone | 919-693-8801
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Fax | 919-693-2401
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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 | 19423
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License Number State | NC
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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 | 051299327
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License Number State | IL
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