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General NPI Number Information
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NPI Number | 1750603205
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Entity Type | Individual
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Provider Name | JANINE DOUGLAS PHARMD, BCPS
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Gender | Female
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 515 N MAIN STREET
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City | WINGATE
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State | NC
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Zip | 28174
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Country | US
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Telephone | 704-233-8974
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Fax |
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Provider Business Mailing Address
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Address Line | 515 N MAIN STREET
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City | WINGATE
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State | NC
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Zip | 28174
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Country | US
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Telephone | 704-233-8974
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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 | 054306-1
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License Number State | NY
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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 | PS48569
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH.03230682-2
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PCT.0012249
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 24793
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License Number State | NC
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