MEDICARE: HEATHER ALLEN PHARMD

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
1	183500000X	Pharmacist	26062	NC

General Provider Information

NPI Number	:	1346691318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER ALLEN PHARMD

Provider Business Mailing Address
First Line	:	2120 WAYNE MEMORIAL DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-1722
Country	:	US
Telephone Number	:	919-731-2423
Fax Number	:	919-731-9918

Provider Business Practice Location Address
First Line	:	2120 WAYNE MEMORIAL DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-1722
Country	:	US
Telephone Number	:	919-731-2423
Fax Number	:	919-731-9918

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2016
Last Update Date	:	06/30/2016

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