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NPI Code Detail

MEDICARE: MR. JEFFREY PHILLIPS PHARMD

MEDICARE: MR. JEFFREY PHILLIPS 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
1183500000XPharmacist19219NC

General Provider Information

NPI Number : 1407178429
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY PHILLIPS PHARMD
Provider Business Mailing Address
First Line : 9158 MARASOL LN
Second Line :
City : CONCORD
State : NC
Zip : 28027-8233
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1906 W INNES ST
Second Line :
City : SALISBURY
State : NC
Zip : 28144-2433
Country : US
Telephone Number : 704-636-7479
Fax Number : 704-636-8954
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2010
Last Update Date : 02/17/2010

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