MEDICARE: DR. LAUREN JESSICA ANNAS 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	23289	NC

General Provider Information

NPI Number	:	1477993012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN JESSICA ANNAS PHARMD

Provider Business Mailing Address
First Line	:	1460 MAY RD
Second Line	:
City	:	GRANITE FALLS
State	:	NC
Zip	:	28630-9230
Country	:	US
Telephone Number	:	828-781-5508
Fax Number	:

Provider Business Practice Location Address
First Line	:	8450 BELLHAVEN BLVD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-6103
Country	:	US
Telephone Number	:	704-392-1369
Fax Number	:

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

Provider Enumeration Date	:	06/27/2013
Last Update Date	:	06/27/2013

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