MEDICARE: LAUREN MORTON JOLLEY

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	19634	NC

General Provider Information

NPI Number	:	1477862431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MORTON JOLLEY

Provider Business Mailing Address
First Line	:	1010 HUNTERSTONE DR APT 104
Second Line	:
City	:	LELAND
State	:	NC
Zip	:	28451-9134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 OLEANDER DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-5149
Country	:	US
Telephone Number	:	910-392-4549
Fax Number	:

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

Provider Enumeration Date	:	09/24/2010
Last Update Date	:	09/24/2010

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Directions to “ LAUREN MORTON JOLLEY ” Practice Location

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