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NPI Code Detail

MEDICARE: DR. TRACI B PIERCE PHARM.D.

MEDICARE: DR. TRACI B PIERCE PHARM.D.
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
1183500000XPharmacist14976NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629380894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACI B PIERCE PHARM.D.
Provider Business Mailing Address
First Line : 297 MEADOW LN
Second Line :
City : MILLERS CREEK
State : NC
Zip : 28651-8954
Country : US
Telephone Number : 336-667-1488
Fax Number : 336-657-2907
Provider Business Practice Location Address
First Line : 1395 W D ST
Second Line :
City : NORTH WILKESBORO
State : NC
Zip : 28659-3505
Country : US
Telephone Number : 336-651-2910
Fax Number : 336-651-2907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2010
Last Update Date : 07/05/2010

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