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NPI Code Detail

MEDICARE: ELLIOTT M. GIFFEN II RPH

MEDICARE:   ELLIOTT M. GIFFEN II RPH
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
1183500000XPharmacist4615NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14615OTHERNCN.C. BOARD OF PHARMACY

General Provider Information

NPI Number : 1982949905
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIOTT M. GIFFEN II RPH
Provider Business Mailing Address
First Line : 2334 SOUTH BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5008
Country : US
Telephone Number : 704-523-8608
Fax Number : 704-523-8619
Provider Business Practice Location Address
First Line : 2334 SOUTH BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5008
Country : US
Telephone Number : 704-523-8608
Fax Number : 704-523-8619
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2012
Last Update Date : 12/03/2012

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Directions to “ ELLIOTT M. GIFFEN II RPH” Practice Location

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