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NPI Code Detail

MEDICARE: EDWARD PLUGOVOY

MEDICARE: EDWARD PLUGOVOY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist27427NC

General Provider Information

NPI Number : 1245759828
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD PLUGOVOY
Provider Business Mailing Address
First Line : 10606 WILLIAMS RD
Second Line :
City : MINT HILL
State : NC
Zip : 28227-9006
Country : US
Telephone Number : 704-756-1699
Fax Number :
Provider Business Practice Location Address
First Line : 2325 VILLAGE LAKE DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-0081
Country : US
Telephone Number : 704-536-3663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2017
Last Update Date : 09/14/2017

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Directions to “ EDWARD PLUGOVOY ” Practice Location

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